Vitamin and Calcium Supplements · What are vitamins, and why are they important? · Calcium · Vitamin D · Folic Acid · Vitamin E · Vitamin A · Vitamin C · Vitamin B12 · Vitamin B6 · Thiamin (vitamin B1) · Niacin · Riboflavin · Vitamin K ( COURTECY;- MEDICINE nET .COM , IT IS NON COMMERTIAL BLOG SHEARING POST )
Vitamin
and Calcium Supplements
·
Calcium
·
Niacin
There are six basic
types of nutrients that are considered essential to life: proteins,
carbohydrates, fats, vitamins, minerals, and water. These nutrients are
needed for your body to function properly, and your diet is the source of them. Vitamins and
minerals are considered micronutrients because they are needed in smaller
quantities than the macronutrients (protein, carbohydrates, and fat).
Micronutrients do not provide calories. When your body does not absorb an
adequate amount of any of the micronutrients, diseases can occur. It's
important to understand what your nutritional needs are and how to achieve
them.
Vitamins are broken
down into two categories: water-soluble and fat-soluble. Water-soluble vitamins
dissolve in water. Leftover amounts are not stored and will leave your body
through your urine. For this reason, you must consume them on a continuous
basis. The water-soluble vitamins are the B vitamins and vitamin C. Fat-soluble vitamins dissolve in
fat, not water. These vitamins need dietary fat in order to be better absorbed
in the small intestines.
They are then stored in the liver and fatty tissues (adipose tissues)
and can accumulate to toxic levels when consumed in excess quantities. The
fat-soluble vitamins are vitamins A, D, E, and K.
Recommendations for
essential nutrients are provided in the Dietary Reference Intakes (DRIs)
developed by the Institute of Medicine of the National Academies. Dietary
Reference Intakes is the general term for a set of reference values used for
planning and assessing nutrient intake for healthy people. There are three
important types of DRI reference values; Recommended Dietary Allowances (RDA),
Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL). The RDA is set
to meet the nutrient requirements for the average daily intake of nearly all
healthy individuals in each age and gender group. When there is insufficient
data to set an RDA for a nutrient, an AI is set. AIs meet or exceed the amount
needed to maintain an adequate nutritional state in nearly everyone of a
specific age and gender group. Some nutrients can cause health problems when
consumed in excessive quantities. The UL was set to provide the maximum daily
intake that is unlikely to result in adverse health effects. Numerous health
conditions, however, can impact your nutritional needs. A registered dietitian
or physician can help you better determine your needs based upon your overall
health and condition.
Author: Betty Kovacs,
MS, RD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
A Viewer
Asks: I've heard that not all calcium supplements are the same. Which
over-the-counter vitamins or minerals help build bones? Which brands or types
are better than others?
Expert
Answer: You heard right, not all calcium supplementsare the same. The
supplements will differ by the kinds of calcium that they contain, the amount
that they contain, and any thing else that is added to them (other minerals or
vitamins).
What is calcium, and what does it do?
Most people know that
calcium is needed for strong bones, but it's also needed to help blood vessels
and muscles contract and expand, to send messages through the nervous system,
and to secrete hormones and enzymes. This is the most abundant mineral in your
body and makes up 1%-2% of adult human body weight.
Over 99% of it is stored in bones and teeth with
the rest stored in blood, muscle, and other tissues.
How much do you need to consume?
There is a great deal
of concern over Americans not meeting the recommendations for calcium intake.
The recommendations for calcium are listed as an Adequate Intake:
Age
|
Adequate
Intake for Calcium
|
0
to 6 months
|
*210
mg from breast milk 315 mg from formula
|
7
to 12 months
|
*270
mg from breast milk 335 mg from formula
|
1
to 3 years
|
500
mg
|
4
to 8 years
|
800
mg
|
9
to 13 years
|
1,300
mg
|
14
to 18 years
|
1,300
mg
|
19
to 50 years
|
1,000
mg
|
51+
years
|
1,200
mg
|
*Breast milk has been
shown to have a higher rate of calcium absorption than formula, so calcium
requirements are higher for formula-based diets. Calcium needs during pregnancy and lactation do not change
from ages 14 to 50.
What are sources of calcium?
Calcium is found in a
variety of foods, but the amount that your body absorbs varies. Oxalic acid and
phytic acid both interfere with the absorption of calcium. Foods rich in oxalic
acid are spinach, rhubarb, sweet potatoes, and beans. Foods rich in phytic acid
are unleavened bread, nuts, seeds, and raw beans. You will absorb some of the
calcium in these foods, but not as much as you would from foods that do not
contain oxalic acid or phytic acid. For example, calcium absorption from dried
beans is about half of what you absorb from milk, and calcium absorption from
spinach is about one-tenth of that absorbed from milk. There is no need to omit
these foods from your diet.
Instead, consume a variety of calcium-rich foods throughout the day.
According to the USDA
Nutrient Database, the calcium content of some common foods is shown below:
Food
|
Amount
|
Calcium
Content
|
Cheese,
cheddar
|
1
½ oz shredded
|
306
mg
|
Collards,
frozen, boiled
|
1
cup
|
357
mg
|
Cottage
cheese, 1% milk fat
|
1
cup
|
138
mg
|
Milk,
nonfat
|
1
cup
|
306
mg
|
Powdered
milk, nonfat
|
1
tbsp
|
50
mg-100 mg
|
Salmon,
canned with bones
|
3
oz
|
181
mg
|
Sardines,
canned in oil, with bones
|
3
oz
|
324
mg
|
Soy milk
|
1
cup
|
93
mg
|
Tofu,
soft, made w/calcium sulfate
|
½
cup
|
138
mg
|
Yogurt,
plain, low-fat
|
1
cup
|
415
mg
|
Yogurt,
fruit, low-fat
|
1
cup
|
245
mg-385 mg
|
You can also increase
your calcium intake by
· adding nonfat powdered milk to cereals (hot
and cold), soups, gravy, baked goods, or
casseroles,
· using nonfat milk in place of water in recipes (pancakes,
pudding, hot cereals, and mashed potatoes), and
· having yogurt dips for vegetable and chips.
Do I need to take a calcium supplement?
A well-balanced diet
can be enough to reach your recommended intake of calcium. When diet is not
enough, a calcium supplement may be necessary. In the case of calcium supplements, more is definitely not better.
Calcium absorption is most efficient when the dose is 500 mg or less. This
means that taking 1,000 mg at one time is less effective than taking two
separate doses of 500 mg.
Calcium exists in
nature combined with other chemicals. These compounds are what you will find
in supplements and
include calcium carbonate, calcium phosphate, calcium
lactate, and calcium citrate. Calcium carbonate is the most common one because
it is inexpensive and convenient. People who have decreased stomach acid (for
example, older adults and those who take antacids) are better off taking
calcium citrate. According to the National Osteoporosis Foundation, "Calcium
supplements prepared from unrefined oyster shell, bone meal, or dolomite may
contain lead or other toxic metals," so you need to pay attention to the
source of calcium in your supplement.
Calcium supplements
may cause gas, bloating, and/or constipation. There may be options to help
relieve this. You can try spreading out dosages of the supplement throughout
the day, try taking it with food, try a different brand, or speak with your
doctor or pharmacist for assistance.
What happens if I do not have enough calcium?
Bone is a living
tissue that constantly breaks down and builds back up. Up until around the age
of 30, consuming an adequate amount of calcium with enough physical activity
ensures that your body builds more bone than it breaks down. The majority of
adult bone mass is acquired by age 18 in girls and 20 in boys. After that,
breakdown typically exceeds the amount of bone being built. For this reason,
it's essential to maximize bone stores when it's still possible. The amount
that you lose after age 30 will be impacted by genetics, ethnicity, physical
activity level, sex hormone levels, diet, and gender. You can replace what you
lose with the foods you eat and your activity level, but you can't increase how
much you store. When bone mass drops and there is a deterioration of bone
tissue, osteoporosis can
occur. Osteoporosis causes
bones to be susceptible to fractures. Depending on the severity of the damage,
bones can break from a minor fall, or in severe cases, from sneezing.
Other factors can put
you at risk for low calcium levels.
Amenorrhea: Research
has shown that young women who do not get their period due to anorexia nervosa have reduced net calcium
absorption, higher urinary calcium excretion, and a lower rate of bone
formation in comparison to those who menstruate regularly. Reduced calcium
retention and lower bone mass have also been seen in exercise-induced amenorrhea.
Lactose intolerance:
Many people find that consuming dairy products causes bloating, gas, cramping,
and/or diarrhea. This is often from your body's
inability to break down the lactose found in dairy foods. Lactose is the sugar that
naturally occurs in these foods. Avoiding dairy foods can put you at risk
for calcium
deficiency. Fortunately, there are things that you can do to help
with these symptoms. The first thing is to try to consume smaller amounts of
dairy foods. Studies have shown that lactose intolerance is dose-dependent and
different people have the intolerance at different levels of severity. When
this doesn't work, you can purchase dairy products that have the lactose broken
down for you. Lactaid products have taken the lactose and broken it up so that
your body does not have to.
Is there such a thing as too much calcium?
The Tolerable Upper
Limit (UL) for calcium for children and adults ages 1 year and older is 2,500
mg/day. Excessively high intakes would have to come from supplements alone or
supplements in combination with dietary sources. The dangers of excessive
consumption are impaired kidney function, hypercalcemia, and decreased absorption of
other minerals (iron, zinc, magnesium, and phosphorus). Calcium has been shown
to interfere with iron absorption. It's best to take the recommended amounts of
calcium separate from iron-containing foods or supplements.
Calcium also has the
potential to interact with medications by decreasing the absorption of the
medication. Some affected medications are digoxin,
fluoroquinolones, levothyroxine, antibiotics in tetracycline family, and phenytoin. Your doctor and pharmacist can
provide further information about this.
What is it, and what does it do?
Vitamin D is probably most well-known for
being the "sunshine vitamin." The ultraviolet rays from sunlight
striking the skin, causing vitamin
D to be made. It can also be found in food and supplements.
This is one of the four fat-soluble vitamins. That means that it's stored in
the body's fatty tissue and can build up to toxic levels with excessive
consumption. The current thinking, however, is that the potential toxicity
of vitamin D has
been exaggerated in the past and it is safe overall.
The major function of
vitamin D is to maintain optimal blood levels of calcium and phosphorus.
Studies have shown that it provides protection from hypertension, cancer,
osteoporosis, type 1 diabetes, and several autoimmune
diseases.
How much do I need to consume?
The recommendations
for vitamin D are listed as an Adequate Intake in micrograms (mcg) and
International Units (IU):
Age
|
Vitamin
D
|
0-12
months
|
10
mcg (400 IU)
|
1
to 13 years
|
15
mcg (600 IU)
|
14
to 18 years
|
15
mcg (600 IU)
|
19
to 50 years
|
15
mcg (600 IU)
|
50
to 71 years
|
15 mcg (600 IU)
|
71+ years
|
20 mcg (800 IU)
|
What are sources of vitamin D?
The sunshine vitamin
got its name from the fact that the sun helps our body produce vitamin D. The
concern about skin cancer has caused many people to
avoid unprotected exposure to the sun. Fortunately, it is possible to consume
enough vitamin D in your diet, so it is not necessary to risk the dangers
of skin
cancer by exposing yourself to the sun. For those who do rely
on the sun as one of their sources, there are many factors that will impact how
much you need. The season, time of day, cloud coverage, smog, amount and SPF of sunscreen, geographic latitude, and melanin content
of your skin are all possible barriers. It can take anywhere from five to 30
minutes of sun on unexposed skin between the hours of 10 a.m. and 3 p.m. at
least twice a week.
The foods that
naturally contain vitamin D are seafood, mushrooms, and egg yolks. Dietary
sources of vitamin D are:
Food
|
Amount
|
Vitamin
D Content
|
Bluefish
|
3
oz
|
415
IU
|
Catfish
|
3
oz
|
425
IU
|
Cod
liver oil
|
1
teaspoon
|
450
IU
|
Egg
yolk
|
1
whole
|
25
IU
|
Mackerel
|
3
oz
|
395
IU
|
Milk,
vitamin D fortified
|
1
cup
|
100
IU
|
Mushrooms,
Chanterelle
|
2
oz
|
50
IU
|
Mushrooms,
Shitake
|
2
oz
|
55
IU
|
Oysters
|
3
oz
|
545
IU
|
Salmon,
farmed
|
3
oz
|
275
IU
|
Salmon,
wild
|
3
oz
|
1,000
IU
|
Sardines,
canned in oil
|
1
¾ oz
|
230
IU
|
Shrimp
|
3
oz
|
120
IU
|
Tuna,
bluefin
|
3
oz
|
170
IU
|
Tuna,
canned in water
|
3
oz
|
135
IU
|
Do I need to take a vitamin D supplement?
When diet is not
enough, you may need to take a supplement to help you reach the desired intake
of vitamin D. As you will see, vitamin D can be toxic at high levels, so the
goal is to reach the appropriate level, not exceed it.
The two primary types
of vitamin D supplements are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Most experts believe that
vitamin D3 is the ideal choice for these reasons:
· Vitamin D3 is the most potent form, it's more
stable on the shelf, and it's less toxic than D2.
· Vitamin D3 is the one that is synthesized when
the sun hits your skin, so it's considered to be the most natural.
· Most of the research that has been done on
vitamin D and its health benefits has used vitamin D3.
What happens if I don't have enough vitamin D?
You can have blood
tests done to determine if you are deficient in vitamin D. Your 25(OH)D level
will be measured. Most experts agree that 25(OH)D level below <20 ng/mL
represents vitamin D deficiency, whereas a 25(OH)D level
below 20 ng/mL is an indication of vitamin D deficiency.
Research has shown
strong relationships between lower rates of chronic diseases and higher levels
of vitamin D. The most well-known disease related to vitamin D deficiency
is rickets. Rickets is the disease that was found
to be cured by consuming cod liver oil in the early 20th century. Rickets
causes soft, weak bones in children, resulting in skeletal deformities (bowed
legs), impaired growth, bone pain,
dental problems, and fragile bones. Unfortunately, rickets has still been seen
in children not being fed an adequate amount of vitamin D. In adults, vitamin D
deficiency can lead to osteoporosis and osteomalacia (both are conditions of
weakened bones).
There are several
other factors that can contribute to a deficiency in vitamin D:
Age: People over 50
years old have a decreased ability to synthesize and absorb vitamin D. This
occurs regardless of the amount of sun exposure time.
Medical conditions:
Vitamin D requires fat for absorption, so anyone with a medical condition that
reduces the ability to absorb dietary fat can be at risk for a deficiency. It
is important to have vitamin D levels monitored in people with conditions such
as Crohn's disease, celiac disease, cystic fibrosis, pancreatic enzyme deficiency,
and surgical removal of any part of the stomach or intestines.
Obesity: Research has
shown lower vitamin D concentrations in overweight and obese individuals. One possible reason
for this is that vitamin D gets absorbed by fat tissue and is not easily
absorbed in the bloodstream.
Sun exposure: The
ultraviolet rays from the sun have served as a source of vitamin D over the
years. Due to the danger of skin cancer,
many people have cut back on their exposure to the sun and have begun using
sunscreen when they are being exposed, so this can contribute to lower levels
if adjustments are not made to compensate for this loss via dietary sources
and/or supplements.
Skin pigmentation:
There is more melanin in darker-skinned individuals. Melanin blocks the
ultraviolet rays and interferes with vitamin D synthesis.
Are there any dangers to consuming too much
vitamin D?
Consuming excessive
amount of vitamin D can pose health problems. This is most likely to occur from
taking supplements or high doses of cod liver oil. There is no danger of
vitamin D toxicity from sun exposure. Symptoms of toxicity can be nausea, poor appetite, weakness, weight loss, constipation,
and high blood levels of calcium. A blood level of over 200 ng/mL for vitamin
D, measured as 25(OH)D, can be potentially toxic. For this reason, the
tolerable upper intake (UL) for vitamin D has been set at 2,000 IU (50 mcg) per
day for ages 1 and above. The UL for birth to 12 months is 1,000 IU (25 mcg)
per day.
Quick GuideVitamin D Deficiency:
How Much Vitamin D Is Enough?
What is folic acid, and what does it do?
Folic acid is the man-made form of
folate, a naturally occurring B vitamin. Because it's a water-soluble vitamin,
it cannot be stored in the body so it needs to be supplied on a continuous
basis.
Folic acid helps form
and maintain new cells. It is needed to make red blood cells and for the metabolism of homocysteine. It helps produce DNA, and it
helps prevent changes in DNA that may lead to cancer.
How much do I need to consume?
The Recommended
Dietary Allowances (RDA) for folate are expressed in a term called Dietary
Folate Equivalent (DFE). The naturally occurring folate is absorbed differently
than the man-made folic acid, so the DFE was developed to help account for
these differences. One DFE is equal to 1 microgram (mcg) of food folate and 0.6
mcg of folic acid from supplements and fortified foods.
The RDA for folate:
Age
|
Males
and Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
150
mcg
|
N/A
|
N/A
|
4
to 8 years
|
200
mcg
|
N/A
|
N/A
|
9
to 13 years
|
300
mcg
|
N/A
|
N/A
|
14
to 18 years
|
400
mcg
|
600
mcg
|
500
mcg
|
19+
years
|
400
mcg
|
600
mcg
|
500
mcg
|
There is insufficient
information to establish an RDA for folate for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
65
mcg
|
7
to 12 months
|
80
mcg
|
What are sources of folic acid?
Folate can be found
naturally in many foods, including fruits, leafy green vegetables, and dried
beans. Folic acid is added to certain foods because of regulations published by
the Food and Drug Administration in 1996. These foods are considered enriched because
the folic acid is replacing the folate that was lost during processing. Some
common folic acid-enriched foods are cereals, breads, pasta, rice, flours, and
cornmeal. Folic acid can also be added to foods and beverages in
addition to the nutrients that they already contain. These foods are considered
fortified with folic acid. In 1998, the folic acid fortification program was
initiated to help Americans reach their folic acid recommendations.
Food sources of folate
and folic acid are:
Food
|
Amount
|
Folate/Folic
Acid Content
|
Asparagus,
cooked
|
4
spears
|
85
mcg
|
Avocado,
sliced, raw
|
½
cup
|
45
mcg
|
Banana,
raw
|
1
medium
|
20
mcg
|
Beef
liver
|
3
oz
|
185
mcg
|
Broccoli,
chopped, frozen, cooked
|
½
cup
|
50
mcg
|
Broccoli,
raw
|
2
spears
|
45
mcg
|
Cantaloupe,
raw
|
¼
medium
|
25
mcg
|
Great
Northern beans
|
½
cup
|
90
mcg
|
Green
peas, frozen, cooked
|
½
cup
|
50
mcg
|
Papaya, raw, cubes
|
½
cup
|
25
mcg
|
Rice,
white, enriched, cooked
|
½
cup
|
65
mcg
|
Spinach,
frozen, cooked
|
½
cup
|
100
mcg
|
Spinach,
raw
|
1
cup
|
60
mcg
|
Tomato
juice
|
6
oz
|
35
mcg
|
Do I need to take a folic acid supplement?
The goal is to consume
a balanced diet that provides your daily folate needs. The folate-enriched and
-fortified foods make this much easier to accomplish. When you have a medical
condition that interferes with the amount that you can consume, if you are unable
to absorb all of what you consume, if your diet is limited, or if you have an
increased need for folate, a supplement would be the best option. It is
recommended that women who may become pregnant take 400 mcg of folic acid from
fortified foods and/or dietary supplements along with consuming a well-balanced
diet.
Another possible
reason to take a supplement would be for heart protection. There are some
studies that have shown that folic acid can lower homocysteine levels by up to
25%. High blood levels of homocysteine can damage the inner surface of blood
vessels, promote blood clotting, accelerate atherosclerosis,
and thus lead to heart attacks and strokes.
What happens if I don't have enough folic
acid?
One very severe
consequence of not getting enough folic acid is the possibility of neural tube defects during pregnancy.
Neural tube defects usually develop in the first 28 days of pregnancy. Many
women do not know that they are pregnant during this time and are not
monitoring their folic acid intake. For this reason, it's a good idea to make
sure that you have an adequate daily intake before trying to conceive.
A deficiency in folate
can lead to megaloblastic (or macrocytic) anemia.
It may also cause poor growth, gray hair, glossitis, mouth ulcers, diarrhea,
and peptic ulcers. Studies have shown that low blood folate levels are
associated with high blood homocysteine levels. High blood levels of
homocysteine can damage the inner surface of blood vessels, promote blood
clotting, accelerate atherosclerosis, and thus lead to heart attacks and
strokes.
There are medical
conditions and medications that can increase the need for folate, increase its
excretion, or interfere with its utilization:
· pregnancy and lactation,
· malabsorption,
· triamterene,
· barbiturates,
· anticonvulsant medications,
· metformin, and
· methotrexate.
It's best to speak
with your doctor if any of these applies to you.
Is there such a thing as too much folic acid?
There is no Tolerable
Upper Limit (UL) set for natural sources of folate found in food.
There are UL set for
folate from fortified foods and supplements.
Age
|
Males
and Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
300
mcg
|
N/A
|
N/A
|
4
to 8 years
|
400
mcg
|
N/A
|
N/A
|
9
to 13 years
|
600
mcg
|
N/A
|
N/A
|
14
to 18 years
|
800
mcg
|
800
mcg
|
800
mcg
|
19+
years
|
1,000
mcg
|
1,000
mcg
|
1,000
mcg
|
What is it, and what does it do?
Vitamin E represents a family of eight
fat-soluble antioxidant vitamins.
Each form has its own function. Alpha-tocopherol is the most important E
vitamin in humans. Vitamin E is involved in maintaining cell integrity, and it
protects vitamin A and essential fatty acids from
oxidation in the body cells.
How much do I need to consume?
The Recommended
Dietary Allowances (RDA) for vitamin E is based on the alpha-tocopherol form.
The recommendations below are in milligrams (mg) and International Units (IU).
You can use the milligrams when looking at the content in food and the
International Units when looking at the content in supplements.
The RDA for vitamin E
is:
Age
|
Males
and Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
6
mg (9 IU)
|
N/A
|
N/A
|
4
to 8 years
|
7
mg (10.5 IU)
|
N/A
|
N/A
|
9
to 13 years
|
11
mg (16.5 IU)
|
15
mg (22.5 IU)
|
19
mg (28.5 IU)
|
14
+ years
|
15
mg (22.5 IU)
|
15
mg (22.5 IU)
|
19
mg (28.5 IU)
|
There is insufficient
information to establish an RDA for vitamin E for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
4
mg (6 IU)
|
7
to 12 months
|
5
mg (7.5 IU)
|
What are sources of vitamin E?
There are many foods
rich in vitamin E. The most common ones are fortified cereals, green leafy
vegetables, vegetable oil, eggs, and nuts. The content of vitamin E in food is
based on the alpha-tocopherol content:
Food
|
Amount
|
Vitamin
E Alpha-tocopherol
|
Almonds,
dry roasted
|
1
oz
|
7.4
mg
|
Broccoli,
frozen, cooked
|
½
cup
|
1.2
mg
|
Corn
oil
|
1
tablespoon
|
1.9
mg
|
Egg
|
1
large
|
5.3
mg
|
Kiwi,
no skin
|
1
medium
|
1.1
mg
|
Mango,
raw
|
½
cup sliced
|
0.9
mg
|
Peanut
butter, smooth style, fortified
|
2
tablespoons
|
4.2
mg
|
Safflower
oil
|
1
tablespoon
|
4.6
mg
|
Soybean
oil
|
1
tablespoon
|
1.3
mg
|
Spinach,
frozen, cooked
|
½
cup
|
1.6
mg
|
Spinach,
raw
|
1
cup
|
0.6
mg
|
Sunflower
oil
|
1
tablespoon
|
5.6
mg
|
Sunflower
seed kernels, dry roasted
|
1
oz
|
6.0
mg
|
Wheat
germ oil
|
1
tablespoon
|
20.3
mg
|
Do I need to take a vitamin E supplement?
Most research shows
that we do not consume an adequate amount of vitamin E, but a deficiency is
rare. According to the USDA, the intake of vitamin E by women 19 to 50 years is
less than 90% of the RDA. The average consumption for American adults is 7 to 9
mg compared to the recommended 15 mg. There is, however, a possibility that we
are consuming more than we think. Many people under-report their fat intake, so
there is a chance that you are reaching your recommended amount of vitamin E if
you do consume a large amount of the oils that contain it. Unfortunately, the
amount of oil that it would take to reach the recommendations is high, and with
that comes a lot of calories. It would be best to consume a variety of the
foods that contain vitamin E with limited amounts of oil and take a supplement
for what you are missing.
There is some evidence
that vitamin E supplements help protect against heart disease, but this evidence is
controversial. In a study of approximately 90,000 nurses, the incidence
of heart
disease was 30%-40% lower in those with the highest intake of
vitamin E from supplements, not from food. This study was looking at what
happened to these nurses without any kind of intervention. The studies that
gave people vitamin E supplements have not seen any protection against heart disease. The
reason for the difference is still unclear, so there is more research being
done to determine what role vitamin E plays in protecting against heart
disease. At this time, the American Heart Association does not recommend
antioxidant vitamins -- including vitamin E --
for preventing cardiovascular
disease.
Some cancers develop
from oxidation damage to DNA. In the Alpha-Tocopherol Beta Carotene (ATBC)
study, scientists found a 32% reduction in the incidence of prostate cancer among subjects taking
alpha-tocopherol supplements compared to those not taking the vitamin. However,
several studies have found no benefit of vitamin E in preventing lung and
breast cancers. More randomized controlled trials are needed to determine the
effect of vitamin E on cancer risks.
Alzheimer's disease is a degenerative
brain disease with progressive loss of mental capacity, thought in part to be
due to oxidation. High doses of alpha-tocopherol supplementation in one study
slowed the progression of Alzheimer's
disease. Although these results are promising, large-scale
placebo-controlled prospective trials will be required to determine the role of
a-tocopherol supplementation in the treatment of Alzheimer's
disease.
When purchasing
vitamin E supplements, you will see that they are often sold as
alpha-tocopheryl acetate. This form of alpha-tocopherol protects its ability to
function as an antioxidant. A "DL" on the label means that it's the
synthetic form and is about half as active as the natural form, which is listed
as "D."
What happens if I don't have enough vitamin E?
Dietary vitamin E
deficiency is common in developing countries and among people with
fat-malabsorption diseases. The main symptoms are hemolytic anemia and
neurologic deficits.
Is there such a thing as too much vitamin E?
Vitamin E can act as
an anticoagulant, which means that it can increase the risk of bleeding
problems. This means that people taking warfarin (Coumadin) should not take vitamin E supplements without
their doctor's approval. The Tolerable Upper Limit (UL) was set at the highest
dose unlikely to result in bleeding problems.
There are UL set for
vitamin E:
Age
|
Males
and Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
200
mg (300 IU)
|
N/A
|
N/A
|
4
to 8 years
|
300
mg (450 IU)
|
N/A
|
N/A
|
9
to 13 years
|
600
mg (900 IU)
|
N/A
|
N/A
|
14
to 18 years
|
800
mg (1,200 IU)
|
800
mg (1,200 IU)
|
800
mg (1,200 IU)
|
19+
years
|
1,000
mg (1,500 IU)
|
1,000
mg (1,500 IU)
|
1,000
mg (1,500 IU)
|
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What is it, and what does it do?
Vitamin A is a fat-soluble
vitamin that is broken down into two categories: preformed vitamin A comes from
animal foods, and provitamin A carotenoid comes from plant foods.
Vitamin A serves many
functions:
· helps regulate the immune system to prevent
and fight infections
· helps form and maintain healthy teeth, skin,
and tissues
· produces the pigments in the retina of
the eye
· promotes good vision
How much do I need to consume?
The Recommended
Dietary Allowances (RDA) for vitamin A are listed as International Units (IU)
of Retinol Activity Equivalents (RAE). This is done to account for the
different actions of both forms of vitamin A.
RDA for vitamin A:
Age
|
Males
|
Females
|
Pregnancy
|
Lactation
|
1
to 3 yrs
|
1,000
IU
|
1,000
IU
|
N/A
|
N/A
|
4
to 8 yrs
|
1,320
IU
|
1,320
IU
|
N/A
|
N/A
|
9
to 13 yrs
|
2,000
IU
|
2,000
IU
|
N/A
|
N/A
|
14
to 18 yrs
|
3,000
IU
|
2,310
IU
|
2,500
IU
|
4,000
IU
|
19+
|
3,000
IU
|
2,310
IU
|
2,565
IU
|
4,300
IU
|
There is insufficient
information to establish an RDA for vitamin A for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
1,320
IU
|
7
to 12 months
|
1,650
IU
|
What are sources of vitamin A?
Vitamin A can be found
in animal and plant foods. The animal food sources are better absorbed and used
by the body than the plant sources. There are also many foods that are
fortified and enriched with vitamin A.
The content of vitamin
A in animal and plant foods (from beta-carotene):
Food
|
Amount
|
Vitamin
A
|
Apricot
nectar, canned
|
½
cup
|
1,651
IU
|
Cantaloupe
|
1
cup cube
|
5,411
IU
|
Carrot
juice, canned
|
½
cup
|
22,567
IU
|
Carrots,
boiled
|
½
cup slices
|
13,418
IU
|
Carrots,
raw
|
1
- 7 ½ inches
|
8,666
IU
|
Cheese,
cheddar
|
1
oz
|
249
IU
|
Kale,
frozen, boiled
|
½
cup
|
9,558
IU
|
Liver,
beef, cooked
|
3
oz
|
27,185
IU
|
Liver,
chicken, cooked
|
3
oz
|
12,325
IU
|
Milk,
fortified skim
|
1
cup
|
500
IU
|
Oatmeal,
instant, fortified
|
1
cup
|
1,252
IU
|
Papaya
|
1
cup cubed
|
1,532
IU
|
Peach
|
1
medium
|
319
IU
|
Peas,
frozen, boiled
|
½
cup
|
1,050
IU
|
Pepper,
red, raw
|
1
ring
|
313
IU
|
Spinach,
frozen, boiled
|
½
cup
|
11,458
IU
|
Spinach,
raw
|
1
cup
|
2,813
IU
|
Vegetable
soup, canned
|
1
cup
|
5,820
IU
|
Do I need to take a vitamin A supplement?
Vitamin A is stored in
the liver, so there is a supply that can be used during short-term periods when
intake is not adequate to meet your needs. People with medical conditions that
interfere with the absorption of vitamin A may need to take a supplement. These
conditions include celiac
disease, Crohn's disease, inflammatory bowel disease, and pancreatic
disorders. Because vitamin A can be toxic at high levels, it's best to discuss
supplements with your physician.
What happens if I don't have enough vitamin A?
Early vitamin A
deficiency leads to impaired night vision, and advanced vitamin A deficiency
can lead to corneal ulcers, xerophthalamia (dry
eye), scarring, night blindness or total blindness. In
developing countries, vitamin A deficiency is an important cause of blindness
among children. Children with vitamin A deficiency are also more likely to
develop diarrhea and respiratory infections than
children who are not vitamin A deficient. Vitamin A deficiency is rare among
healthy adults in the United States.
Vitamin A deficiency
can also be a problem for people with Crohn's
disease, celiac
disease, pancreatic disorders, and people who do not consume animal
foods.
Is there such a thing as too much vitamin A?
When excess amounts of
vitamin A are being stored in your body, the condition is called
hypervitaminosis A. The harmful effects of hypervitaminosis A are birth defects, reduced bone
density that may result in osteoporosis, central nervous system
disorders, and liver abnormalities.
Acute vitamin A
toxicity may result from consuming very large quantities of vitamin A over a short
period of time. The symptoms are nausea, vomiting, irritability, drowsiness, altered mental status, anorexia, abdominal pain, blurred vision, muscle pain with weakness, and/or headache. Elderly people and people who drink alcohol
heavily are more susceptible to vitamin A toxicity.
The Institute of
Medicine states that "beta-carotene supplements are not advisable for the
general population," although they also state that this advice "does
not pertain to the possible use of supplemental beta-carotene as a provitamin A
source for the prevention of vitamin A deficiency in
populations with inadequate vitamin A."
The Tolerable Upper
Limit (UL) for vitamin A is:
Age
|
Males
and Females
|
Pregnancy
|
Lactation
|
0
to 1 year
|
2,000
IU
|
N/A
|
N/A
|
1
to 3 years
|
2,000
IU
|
N/A
|
N/A
|
4
to 8 years
|
3,000
IU
|
N/A
|
N/A
|
9
to 13 years
|
5,610
IU
|
N/A
|
N/A
|
14
to 18 years
|
9,240
IU
|
9,240
IU
|
9,240
IU
|
19+
years
|
10,000
IU
|
10,000
IU
|
10,000
IU
|
In the ATBC trial,
subjects given beta-carotene had a higher incidence of lung cancerthan subjects not given
beta-carotene. The Institute of Medicine did not set ULs for carotene or carotenoids.
However, the recommendation is that beta-carotene supplements are not advisable
for the general population.
What is it, and what does it do?
Vitamin C, also known
as ascorbic acid, is a water-soluble antioxidant
vitamin. Vitamin C is required for the synthesis of collagen and dentin.
Collagen is the structural component of blood vessels, bones, ligaments, and
tendons, while dentin is the structural component of teeth. Vitamin C is also
an effective antioxidant that protects proteins and genetic materials (RNA and
DNA) from damage by free radicals. Vitamin C cannot be made or stored by your
body, so it's important to consume a well-balanced diet containing vitamin C.
How much do I need to consume?
There is insufficient
information to establish an RDA for vitamin C for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
40
mg/day
|
7
to 12 months
|
50
mg/day
|
The Recommended
Dietary Allowance (RDA) for vitamin C is:
Age
|
Males
|
Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
15
mg
|
15
mg
|
N/A
|
N/A
|
4
to 8 years
|
25
mg
|
25
mg
|
N/A
|
N/A
|
9
to 13 years
|
45
mg
|
45
mg
|
N/A
|
N/A
|
14
to 18 years
|
75
mg
|
65
mg
|
80
mg
|
115
mg
|
19
+ years
|
90
mg/day
|
75
mg/day
|
85
mg/day
|
120
mg/day
|
What are sources of vitamin C?
All fruits and
vegetables contain some amount of vitamin C, so consuming a well-balanced diet
with plenty of fruits and vegetables is the key.
Food
|
Amount
|
Vitamin
C
|
Broccoli,
cooked
|
½
cup
|
37
mg
|
Broccoli,
raw
|
½
cup
|
39
mg
|
Brussels
sprouts, cooked
|
½
cup
|
48
mg
|
Cantaloupe
|
¼
medium
|
47
mg
|
Cauliflower,
cooked
|
½
cup
|
28
mg
|
Grapefruit
juice
|
¾
cup
|
50
mg-70 mg
|
Green
pepper, cooked
|
½
cup
|
51
mg
|
Green
pepper, raw
|
½
cup
|
60
mg
|
Guava,
raw
|
½
cup
|
188
mg
|
Kale,
cooked
|
½
cup
|
27
mg
|
Kiwi
|
1
medium
|
70
mg
|
Mango
|
½
cup
|
23
mg
|
Orange
|
1
medium
|
70
mg
|
Orange
juice
|
¾
cup
|
61
mg-93 mg
|
Papaya
|
¼
medium
|
47
mg
|
Pineapple,
raw
|
½
cup
|
28
mg
|
Pod
peas, cooked
|
½
cup
|
38
mg
|
Red
sweet pepper, cooked
|
½
cup
|
116
mg
|
Red
sweet pepper, raw
|
½
cup
|
142
mg
|
Strawberries
|
½
cup
|
49
mg
|
Sweet
potato, canned
|
½
cup
|
34
mg
|
Tomato
juice
|
¾
cup
|
33
mg
|
Vegetable
juice
|
¾
cup
|
50
mg
|
Do I need to take a vitamin C supplement?
Many people believe
that taking vitamin C will help prevent colds. Research has not shown this to
be the case. More than 30 clinical trials that included over 10,000
participants have not found any relationship between vitamin C and a reduced
risk of colds. There has been a small reduction in the duration of colds, so
paying attention to your vitamin C intake once you have the cold is advisable.
Research has shown
that vitamin C enhances the absorption of iron. For this reason, anyone who
needs an iron supplement is usually advised to take it with a food that is high
in vitamin C or with a vitamin C supplement. Iron can be toxic at high levels,
so speak with your doctor before taking any supplements.
There is an increased
need for vitamin C for individuals who smoke. There is an additional 35 mg/day
requirement for smokers versus nonsmokers. This can be achieved with dietary
sources or a supplement.
What happens if I don't have enough vitamin C?
Scurvy is
a severe deficiency of vitamin C. It would be uncommon for most of us, but it
can be found in someone who is malnourished. Less severe deficiencies can
occur. Not consuming an adequate amount of vitamin C can lead to symptoms,
including feeling weak, tired, and irritable, having dry and splitting
hair, bleeding gums, rough, dry, and scaly
skin, gingivitis,
easy bruising, anemia, and a decreased ability to fight infection.
Is there such a thing as too much vitamin C?
Vitamin C is generally
safe. Large doses of vitamin C may cause stomach upset and diarrhea in adults
and have been reported to cause kidney stones. There is also a risk of excess
iron absorption with high doses of vitamin C.
What is it, and what does it do?
Vitamin B12 is needed
for producing and maintaining new cells, including nerve cells and red blood
cells. It is also needed to help make DNA.
Vitamin B12 is bound
to the proteins in food. Once you consume B12, the hydrochloric acid in your
stomach releases the B12 from the protein. B12 then combines with a substance
called intrinsic factor to be absorbed by the intestines.
How much do I need to consume?
There is insufficient
information to establish an RDA for vitamin B12 for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
0.4
mcg/day
|
7
to 12 months
|
0.5
mcg/day
|
The Recommended
Dietary Allowance (RDA) for vitamin B12 is:
Age
|
Males
and Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
0.9
mcg
|
N/A
|
N/A
|
4
to 8 years
|
1.2
mcg
|
N/A
|
N/A
|
9
to 13 years
|
1.8
mcg
|
N/A
|
N/A
|
14
to 19 years
|
2.4
mcg
|
2.6
mcg
|
2.8
mcg
|
19+
years
|
2.4
mcg/day
|
2.6
mcg/day
|
2.8
mcg/day
|
What are sources of vitamin B12?
Vitamin B12 is
attached to the proteins in animal foods. Breakfast cereals are fortified with
vitamin B12, which is very important for people who do not consume an adequate
amount of animal foods.
Food
|
Amount
|
Vitamin
B12
|
Beef,
top sirloin, lean, choice, broiled
|
3
oz
|
2.4
mcg
|
Breakfast
cereals, fortified
|
¾
cup
|
6
mcg
|
Chicken,
breast, cooked
|
½
breast
|
0.3
mcg
|
Egg
|
1
large
|
0.6
mcg
|
Haddock,
cooked
|
3
oz
|
1.2
mcg
|
Liver,
beef
|
1
slice
|
47.9
mcg
|
Milk
|
1
cup
|
0.9
mcg
|
Mollusks,
clam
|
3
oz
|
84.1
mcg
|
Salmon,
sockeye, cooked
|
3
oz
|
4.9
mcg
|
Trout,
rainbow, farmed, cooked
|
3
oz
|
4.2
mcg
|
Trout,
rainbow, wild, cooked
|
3
oz
|
5.4
mcg
|
Tuna,
white, canned in water
|
3
oz
|
1.0
mcg
|
Yogurt,
plain, skim
|
1
cup
|
1.4
mcg
|
Do I need to take a vitamin B12 supplement?
Studies reveal that
the majority of Americans consume an adequate amount of vitamin B12. People who
do not consume meat or who have a stomach or intestinal disorder that
interferes with absorption may need to take a vitamin B12 supplement. Older
adults may have atrophic gastritis and may need to consume
additional food sources and/or supplements. There are also some medications
that can influence vitamin B12 absorption, including H2 receptor antagonists
used to treat peptic ulcers, metformin, and proton pump inhibitors. Your doctor can
determine your vitamin B12 levels with a blood test.
What happens if I don't have enough vitamin
B12?
An inadequate amount
of vitamin B12 can cause pernicious anemia. Signs of vitamin B12
deficiency are fatigue, constipation, weakness, loss of appetite, weight
loss, and numbness and tingling in the hands and feet. You may also
experience a difficulty in maintaining balance, confusion, dementia, depression, and poor memory. An excess intake
of folate can mask the symptoms of B12 deficiency, so it's important to have
your levels checked with blood tests if there is a concern, especially if you
consume a vegetarian diet.
Is there such a thing as too much vitamin B12?
Currently, there is no
Tolerable Upper Limit set for vitamin B12. This does not mean that consuming
excessive amounts will provide any additional health benefits. It means that
there is a very low potential for toxicity at high levels.
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What is vitamin B6,
and what does it do?
Vitamin B6 is one of
the water-soluble B vitamins. It comes in three forms: pyridoxine, pyridoxal, and pyridoxamine. It
serves numerous functions in your body, including
· red blood cell metabolism,
· making hemoglobin,
· assisting in the proper functioning of the
nervous system,
· assisting in the proper functioning of the
immune system,
· protein metabolism, and
· synthesis of serotonin and
norepinephrine.
How much vitamin B6 do I need to consume?
The Recommended
Dietary Allowance (RDA) for vitamin B6 is:
Age
|
Males
|
Females
|
Pregnancy
|
Lactation
|
1
to 3 yrs
|
0.5
mg
|
0.5
mg
|
N/A
|
N/A
|
4
to 8 yrs
|
0.6
mg
|
0.6
mg
|
N/A
|
N/A
|
9
to 13 yrs
|
1.0
mg
|
1.0
mg
|
N/A
|
N/A
|
14
to 18 yrs
|
1.3
mg
|
1.2
mg
|
1.9
mg
|
2.0
mg
|
19
to 50 yrs
|
1.3
mg
|
1.3
mg
|
1.9
mg
|
2.0
mg
|
51+
yrs
|
1.7
mg
|
1.5
mg
|
N/A
|
N/A
|
There is insufficient
information to establish an RDA for vitamin B6 for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
0.1
mg/day
|
7
to 12 months
|
0.3
mg/day
|
What are sources of vitamin B6?
Vitamin B6 is found
naturally in many foods and can also be found in foods that are fortified with
it:
Food
|
Amount
|
Vitamin
B6
|
Avocado,
raw, California
|
1
oz
|
0.08
mg
|
Banana
|
1
medium
|
0.43
mg
|
Cereal,
100% fortified
|
¾
cup
|
2
mg
|
Chicken
breast, meat only
|
3
oz
|
0.52
mg
|
Garbanzo
beans
|
½
cup
|
0.51
mg
|
Lima
beans, frozen, cooked
|
½
cup
|
0.10
mg
|
Oatmeal,
instant, fortified
|
1
packet
|
0.42
mg
|
Peanut
butter, smooth
|
1
tablespoon
|
0.09
mg
|
Pistachio
nuts, dry roasted
|
1
oz (47 nuts)
|
0.36
mg
|
Pork
loin, cooked
|
3
oz
|
0.42
mg
|
Potato,
with skin
|
1
medium
|
0.47
mg
|
Roast
beef, eye of round, cooked
|
3
oz
|
0.42
mg
|
Salmon,
Sockeye, cooked
|
3
oz
|
0.19
mg
|
Soybeans,
green
|
½
cup
|
0.05
mg
|
Spinach,
frozen, cooked
|
½
cup
|
0.14
mg
|
Sunflower
seeds, kernels
|
1
oz
|
0.23
mg
|
Tomato
juice, canned
|
8
oz
|
0.27
mg
|
Trout,
rainbow, cooked
|
3
oz
|
0.29
mg
|
Tuna,
canned in water
|
3
oz
|
0.18
mg
|
Walnuts,
English/Persian
|
1
oz
|
0.15
mg
|
Wheat
bran
|
¼
cup
|
0.18
mg
|
Yogurt,
plain, skim milk
|
8
oz
|
0.12
mg
|
Do I need to take a vitamin B6 supplement?
Vitamin B6 is
available as pyridoxine hydrochloride in supplements. The requirements for
vitamin B6 can easily be met with a well-balanced diet. When your diet is
limited in variety, you may need to take a supplement. Older adults and
alcoholics are people whose diets may be lacking and require supplementation.
Studies have shown that supplementing with large doses of vitamin B6 can
increase the immune response in critically ill patients.
What happens if I don't have enough vitamin
B6?
In the early 1950s, an
error in the manufacturing of baby formula lead to vitamin B6 deficiencies and
caused seizures in the infants who were
deficient in it. Other symptoms of vitamin B6 deficiency are depression,
confusion, sores or ulcers on the mouth, ulcers at the corners of the mouth,
confusion, and irritability.
Is there such a thing as too much vitamin B6?
There are no
documented health problems associated with consuming vitamin B6 from food
sources. There have been problems associated with excess supplementation of
vitamin B6. Large doses, above 1,000 mg/day, have been shown to cause sensory
neuropathy. Symptoms of this include difficulty walking and painand numbness
of the extremities. There have even been some reported cases of this with doses
under 500 mg/day. Even though this is a water-soluble vitamin, limits had to be
set on how much can be safely consumed.
The Tolerable Upper
Limit (UL) for vitamin B6 was set for the general population:
Age
|
Males
and Females
|
1
to 3 years
|
30
mg/day
|
4
to 8 years
|
40
mg/day
|
9
to 13 years
|
60
mg
|
14
to 18 years
|
80
mg
|
19+
years
|
100
mg
|
What is thiamin, and
what does it do?
Thiamin is another one
of the water-soluble B vitamins. It was previously known as vitamin B1 or
aneurine and can also be spelled thiamine. Thiamin is involved in numerous
functions:
· metabolism of carbohydrates,
· nervous system functioning,
· producing hydrochloric acid,
· muscle functioning,
· flow of electrolytes in and out cells, and
· multiple enzyme processes.
How much thiamin do I
need to consume?
The Recommended
Dietary Allowance for thiamin is:
Age
|
Males
|
Females
|
Pregnancy
|
Lactation
|
1
to 3 yrs
|
0.5
mg
|
0.5
mg
|
||
4
to 8 yrs
|
0.6
mg
|
0.6
mg
|
||
9
to 13 yrs
|
0.9
mg
|
0.9
mg
|
||
14
to 18 yrs
|
1.2
mg
|
1.0
mg
|
||
19+
years
|
1.2
mg
|
1.1
mg
|
||
All
Ages
|
1.4
mg
|
1.4
mg
|
There is insufficient
information to establish an RDA for thiamin for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
0.2
mg
|
7
to 12 months
|
0.3
mg
|
What are sources of
thiamin?
Food
|
Amount
|
Thiamin
Content
|
Beans,
black, cooked
|
1
cup
|
0.42
mg
|
Bread,
white, enriched
|
1
slice
|
0.11
mg
|
Bread,
whole wheat
|
1
slice
|
0.10
mg
|
Cantaloupe
|
½
fresh
|
0.11
mg
|
Carrot
juice, canned
|
1
cup
|
0.217
mg
|
Cereal,
fortified
|
1
cup
|
0.5
mg-4.0 mg
|
Cereal,
wheat germ
|
1
cup
|
4.47
mg
|
Egg,
whole
|
1
large
|
0.03
mg
|
Lentils,
cooked
|
½
cup
|
0.17
mg
|
Long
grain brown rice, cooked
|
1
cup
|
0.19
mg
|
Long
grain white rice, enriched, cooked
|
1
cup
|
1.06
mg
|
Long
grain, white rice, not enriched, cooked
|
1
cup
|
0.25
mg
|
Milk
|
1
cup
|
0.10
mg
|
Nuts,
Brazil
|
1
oz (6-8)
|
0.18
mg
|
Nuts,
pecans
|
1
oz (20 halves)
|
0.19
mg
|
Orange
|
1
medium
|
0.10
mg
|
Peas,
cooked
|
½
cup
|
0.21
mg
|
Pecans
|
1
oz
|
0.19
mg
|
Pork,
cooked
|
3
oz
|
0.72
mg
|
Spinach,
cooked
|
½
cup
|
0.09
mg
|
Do I need to take a thiamin supplement?
Your body can run out
of the small amount of thiamin that it can store in only 14 days, so you need
to consume it on a consistent basis. Thiamin deficiency has been seen in people
taking strong diuretics and in alcoholics. Thiamin can also be lost during cooking.
One study determined the amount lost based on the source of thiamin and cooking
method and found
· 20%-35% lost in water that is discarded after
cooking vegetables,
· 43% loss in pork loin that is roasted (three
times as much as lost during braising),
· 15% loss in bread that is baked, and
· no loss in double broiler cooking of whole
grain cereals.
Thiamin can be in the
form of thiamin hydrochloride and thiamin mononitrate in multivitamins, B complex vitamins, or
individual supplements.
What happens if I don't have enough thiamin?
Thiamin was one of the
first vitamins to be discovered. A deficiency in thiamin can cause
weakness, fatigue,
nerve damage, and psychosis. Beriberi is the disease that is caused by a severe
thiamin deficiency. Beriberi is categorized as wet, dry, or cerebral, depending
on the systems that it affects. Wernicke-Korsakoff syndrome can also be caused
by a severe thiamin deficiency. Brain damage can occur as a result of
this.
Is there such a thing as too much thiamin?
Thiamin is safe enough
that no tolerable upper limit (UL) has been established for it. There are no
health benefits from extremely high supplementation, so there is no need to
take excessive quantities.
What is niacin, and what does it do?
Niacin is
a water-soluble B vitamin that is also known as vitamin B3, nicotinamide, or
nicotinic acid. Niacin assists in the proper functioning of the nervous
and digestive system, maintaining healthy skin,
and conversion of food to energy.
How much niacin do I need to consume?
There is insufficient
information to establish an RDA for niacin for infants. In this case, an
Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
2
mg
|
7
to 12 months
|
4
mg
|
The Recommended
Dietary Allowance (RDA) for niacin is:
Age
|
Males
|
Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
6
mg
|
6
mg
|
N/A
|
N/A
|
4
to 8 years
|
8
mg
|
8
mg
|
N/A
|
N/A
|
9
to 13 years
|
12
mg
|
12
mg
|
N/A
|
N/A
|
14
to 18 years
|
16
mg
|
14
mg
|
18
mg
|
17
mg
|
19+
years
|
16
mg
|
14
mg
|
18
mg
|
17
mg
|
What are sources of niacin?
Niacin is found in
animal products, nuts, green vegetables, legumes, and enriched and fortified
cereals.
Food
|
Amount
|
Niacin
Content
|
Bagel
|
4"
|
3.06
mg
|
Barley,
pearled, cooked
|
1
cup
|
3.24
mg
|
Beans,
kidney, red, boiled
|
1
cup
|
1.02
mg
|
Beef,
eye of round, roasted
|
3
oz
|
5.24
mg
|
Bread,
rye
|
1
slice
|
1.22
mg
|
Carrots,
cooked
|
1
cup
|
1.01
mg
|
Cereal,
fortified
|
1
cup
|
5.00
mg
|
Ham,
sliced, extra lean
|
2
slices
|
2.23
mg
|
Mango,
raw
|
1
mango
|
1.21
mg
|
Milk,
nonfat
|
1
cup
|
0.23
mg
|
Peanut
butter, smooth
|
1
tablespoon
|
2.14
mg
|
Peas,
frozen, cooked
|
1
cup
|
2.37
mg
|
Potato,
no skin
|
1
cup
|
2.05
mg
|
Rice,
brown, long-grain, cooked
|
1
cup
|
2.98
mg
|
Soybeans,
cooked
|
1
cup
|
2.25
mg
|
Tomato,
canned, sauce
|
1
cup
|
2.39
mg
|
Do I need to take a
niacin supplement?
A well-balanced diet
can provide enough niacin to reach your needs. When you have a medical need, a
deficiency, or an inadequate diet, you should consult with your physician
before taking a niacin supplement. High doses must be prescribed by a physician
since niacin can be used as a drug (see below). Niacin supplements come in
several forms: niacin, inositol hexaniacinate, and niacinamide
What happens if I don't have enough niacin?
Niacin was discovered
in low-income populations where corn products were the primary source of
calories, and the disease pellagra was occurring. The symptoms of pellagra are
known as the four Ds: dermatitis, diarrhea, dementia,
and death. Pellagra occurs at the late stage of niacin deficiency. Niacin
deficiency symptoms will involve the digestive system (diarrhea, vomiting, and bright red tongue), the skin
(thick, scaly skin and dark pigmented rash that
develops symmetrically in areas exposed to sunlight), and the nervous system (fatigue, depression, headache,
apathy, disorientation, and memory loss).
Is there such a thing as too much niacin?
Doses much higher than
the ULs are used medically to improve cholesterol
levels. High doses of niacin can cause dangerous liver inflammation,
peptic ulcers, and skin rashes. "Niacin flushing" is a side effect
that causes redness, itching, and burning and can occur within 10
to 15 minutes after taking it and can last up to one hour. Research has shown
that there are conditions that make people susceptible to these symptoms,
including diabetes
mellitus, gout, cardiac arrhythmias, hepatic dysfunction
or a history of liver disease, migraine headaches, alcoholism, and inflammatory
bowel disease. These conditions may not be protected by the UL that
has been set for the general population, so extreme caution needs to be used
when taking niacin supplements. For everyone, the only time that high doses of
niacin should be taken would be under the supervision of your physician.
The Tolerable Upper
Limit (UL) for niacin is:
Age
|
Males
and Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
10
mg/day
|
N/A
|
N/A
|
4
to 8 years
|
15
mg/day
|
N/A
|
N/A
|
9
to 13 years
|
20
mg/day
|
N/A
|
N/A
|
14
to 18 years
|
30
mg/day
|
30
mg/day
|
30
mg/day
|
19+
years
|
30
mg/day
|
35
mg/day
|
35
mg/day
|
What is riboflavin, and what does it do?
Riboflavin is one of
the water-soluble B vitamins and is also known as vitamin B2. It is needed for
converting food to energy, works as an antioxidant by scavenging damaging free
radicals, and is needed to convert vitamin B6 and folate into active forms.
How much riboflavin do I need to consume?
There is insufficient
information to establish an RDA for vitamin riboflavin for infants. In this
case, an Adequate Intake (AI) has been established:
Age
|
Males
and Females
|
0
to 6 months
|
0.3
mg
|
7
to 12 months
|
0.4
mg
|
The Recommended
Dietary Allowance (RDA) for riboflavin is:
Age
|
Males
|
Females
|
Pregnancy
|
Lactation
|
1
to 3 years
|
0.5
mg
|
0.5
mg
|
N/A
|
N/A
|
4
to 8 years
|
0.6
mg
|
0.6
mg
|
N/A
|
N/A
|
9
to 13 years
|
0.9
mg
|
0.9
mg
|
N/A
|
N/A
|
14
to 18 years
|
1.3
mg
|
1.0
mg
|
1.4
mg
|
1.6
mg
|
19
+ years
|
1.3
mg
|
1.1
mg
|
1.4
mg
|
1.6
mg
|
What are sources of riboflavin?
Though riboflavin can
be found in most animal and plant foods, it is destroyed by light, so these
foods need to be stored away from light to protect it. It can be lost in the
water if foods are boiled or soaked, so avoid doing this or consume the water along
with the food (for example, soup).
Food
|
Amount
|
Riboflavin
Content
|
Asparagus,
cooked
|
4
spears
|
0.08
mg
|
Broccoli,
cooked
|
1
cup
|
0.15
mg
|
Cereal,
fortified
|
1
cup
|
0.42
mg
|
Egg,
cooked
|
1
large
|
0.24
mg
|
Milk,
nonfat
|
1
cup
|
0.45
mg
|
Nuts,
cashews, dry roasted
|
1
oz
|
0.06
mg
|
Peaches,
raw
|
1
cup
|
0.05
mg
|
Peas,
frozen, cooked
|
1
cup
|
0.16
mg
|
Raisins
seedless
|
1
cup
|
0.18
mg
|
Spaghetti,
cooked, enriched
|
1
cup
|
0.19
mg
|
Spinach,
cooked
|
1
cup
|
0.43
mg
|
Do I need to take a riboflavin supplement?
A well-balanced diet
can provide enough riboflavin to reach your RDA. When your diet is limited in
variety or you have a medical condition that interferes with the absorption of
riboflavin, you may need a supplement. The most common forms of riboflavin found
in supplements are riboflavin 5-monophosphate and riboflavin. These can be
purchased alone, in a multivitamin, or in a B complex supplement.
What happens if I don't have enough
riboflavin?
Riboflavin deficiency
can occur from not consuming enough in your diet and from conditions that
decrease the amount absorbed, including malabsorption syndromes, chronic
diarrhea, long-term use of barbiturates, peritoneal dialysis, and alcoholism. Ariboflavinosis is caused by
riboflavin deficiency. The symptoms include fatigue, cracks and sores around
the corners of the mouth (angular stomatitis/cheilosis), eye fatigue, swollen
magenta tongue (glossitis), skin irritation (dermatitis), soreness and swelling
of the throat, sensitivity to light, and eye fatigue.
Is there such a thing as too much riboflavin?
No Tolerable Upper
Limit (UL) has been set for riboflavin. Possible reactions to very high doses
include burning/prickling sensations, itching,
numbness, and yellow discoloration of the urine. There is also a possibility
that riboflavin's photosensitizing (sensitivity to light) properties can pose
health risks.
What is vitamin K, and what does it do?
Vitamin K is a fat-soluble vitamin known
for its role in blood clotting. There are three main types of vitamin K:
vitamin K1 (phytonadione) if the natural form found in plants; vitamin K2
(menaquinones) is made by the human gut; and vitamin K3 (menadione) is the
water-soluble form that is made for use in supplements.
People taking the
blood-thinning medication warfarin (Coumadin) are at an increased risk for
blood clotting. Warfarin works by decreasing the activity of vitamin K,
lengthening the time it takes for a clot to form. The goal for vitamin K intake
while taking warfarin is to keep your intake constant. This does not mean that
you can't consume any vitamin K-containing foods. Instead, you want to consume
a consistent amount so that the dose of warfarin that you are taking is working
on the same amount. Sudden increases and/or decreases in vitamin K while taking
warfarin can cause problems.
How much vitamin K do I need to consume?
There is no data to
establish RDAs for vitamin K. Therefore, Adequate Intakes (AI) have been
established:
Age
|
Males
|
Females
|
Pregnancy
|
Lactation
|
0
to 6 months
|
2.0
mcg
|
2.0
mcg
|
N/A
|
N/A
|
7
to 12 months
|
2.5
mcg
|
2.5
mcg
|
N/A
|
N/A
|
1
to 3 years
|
30
mcg
|
30
mcg
|
N/A
|
N/A
|
4
to 8 years
|
55
mcg
|
55
mcg
|
N/A
|
N/A
|
9
to 13 years
|
60
mcg
|
60
mcg
|
N/A
|
N/A
|
14
to 18 years
|
75
mcg
|
75
mcg
|
75
mcg
|
75
mcg
|
19+
years
|
120
mcg
|
90
mcg
|
90
mcg
|
90
mcg
|
What are sources of vitamin K?
Vitamin K is found
primarily in green leafy vegetables and fruit. It can also be found in some
animal foods.
Food
|
Amount
|
Vitamin
K Content
|
Banana
|
1
medium
|
0.6
mcg
|
Beans,
kidney, red, cooked
|
1
cup
|
14.9
mcg
|
Blueberries,
raw
|
1
cup
|
28
mcg
|
Broccoli,
raw
|
1
cup
|
89.4
mcg
|
Brussels
sprouts, frozen, cooked
|
1
cup
|
299.9
mcg
|
Cabbage,
cooked, boiled
|
1
cup
|
163.1
mcg
|
Carrot
juice, canned
|
1
cup
|
36.6
mcg
|
Collards,
frozen, chopped, cooked
|
1
cup
|
1,059
mcg
|
Dandelion greens, cooked
|
1
cup
|
579.0
mcg
|
Endive,
raw
|
1
cup
|
115.5
mcg
|
Kale,
frozen, cooked
|
1
cup
|
1,146.6
mcg
|
Lettuce,
green leaf, raw
|
1
cup
|
97.2
mcg
|
Mustard
greens, cooked
|
1
cup
|
419.3
mcg
|
Onions,
spring or scallion
|
1
cup
|
207.0
mcg
|
Spinach,
frozen, cooked
|
1
cup
|
1,027.3
mcg
|
Turnip
greens, frozen, cooked
|
1
cup
|
851.0
mcg
|
Do I need to take a vitamin K supplement?
A well-balanced diet
can provide an adequate amount of vitamin K. There are conditions that can
interfere with the absorption of vitamin K, including celiac disease, ulcerative colitis, cystic fibrosis, biliary
obstruction, regional enteritis, or intestinal resection. Medications
that alter your liver function or kill the intestinal
flora can also negatively impact your vitamin K levels. These medications
include antibiotics, antiseizure medications, salicylates, and some sulfa drugs.
What happens if I don't have enough vitamin K?
Vitamin K is needed by
the liver to make factors that are necessary for blood to clot properly. A
deficiency in vitamin K can lead to defective blood clotting and increased
bleeding.
Is there such a thing as too much vitamin K?
The Tolerable Upper
Limit (UL) for vitamin K has not been established. Amounts exceeding 1,000
times the AI can promote formation of blood clots(thrombogenesis), breakdown of red
blood cells (hemolysis), and raise the risk of jaundice.
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