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Vitamins &
Supplements
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Vitamins & Supplements
Index
Vitamins
Supplements
Vitamin A
Vitamin B12
Vitamin B6
Vitamin C
Calcium
Vitamin D
Vitamin E
Folate
Iodine
Iron
Vitamin K
Magnesium
Zinc
Multi-Vitamins
2
Vitamins & Supplements
Vitamins
Vitamins are organic compounds containing carbon which is essential for life. They are either water
or fat soluble meaning they either need water or fat to be digested and absorbed.
Water soluble include (all are B-vitamins expect for Vitamin C):
Vitamin C
Thiamin
Riboflavin
Niacin
B6
B12
Folic acid
Biotin
Pantothenic acid
Fat soluble include:
Vitamin A
Vitamin D
Vitamin E
Vitamin K
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Vitamins & Supplements
Vitamins
Vitamin A
Active form is retinal
Inactive form (which is activated by the body) is carotene (i.e. beta carotene found in carrots)
Vital for vision especially night vision
Needed for repair of tissue and bone
Involved in reproduction and fetal development
Helps immune system function
Food sources include whole eggs, dairy, beef liver, dark green vegetables, yellow/orange
colored vegetables
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Vitamins & Supplements
Vitamins
B-Vitamins
Group of vitamins all involved in turning the food we eat into useable energy by the body
Include thiamin, riboflavin, niacin, B6, B12, folic acid, biotin, pantothenic acid
Some B vitamins work solely to turn the food we eat into useable energy, others have
additional roles
Thiamin (B1) assists the nervous system, heart muscle and regulates appetite
Riboflavin (B2) plays a role in mucous membrane formation and skin formation
B6 helps maintain normal homocysteine levels in the blood, which is an amino acid that helps
reduce the risk of heart disease
Folic acid (B9) helps form the brain and spinal cord during fetal development and is involved in
cell division and red blood cell formation
B-vitamins are widespread in the food supply. Found mostly in green vegetables, meats, dairy
and fortified foods
B12 is the only B-vitamin not found in plant foods and therefore needs to be supplemented for
those who are vegan
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Vitamins & Supplements
Vitamins
Vitamin C
Also known as ascorbic acid
Functions as antioxidant
Assists formation of collagen
Needed for wound healing
Decreases risk of cancer and heart disease
Found in fruits, vegetables especially citrus, bell peppers, kiwi, broccoli, strawberries, tomatoes,
watermelon, potatoes, bananas and carrots
Vitamin D
Known as the sunshine vitamin because we get most of what we need from sun exposure
Needed for calcium absorption
Helps maintain bones and teeth
Prevents rickets and osteoporosis
Assists in immune function, cell growth and fetal development
Lately has been shown to reduce risks of some cancers
Found in fatty fish, cod liver oil, dairy that has been fortified, egg yolks and beef liver
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Vitamins & Supplements
Vitamins
Vitamin E
Acts as an antioxidant
Contributes to immune function and DNA repair
Sources include vegetable oil, nuts, beans, whole grains and fortified cereals
Vitamin K
Plays an essential role in blood clotting
Main source is green leafy vegetables, cabbage, beef liver
Synthesized somewhat by the bacteria in the large intestine so we get some of what we need
by our own body production
Vitamin Vacation:
Did you know that you should not be taking vitamins every day for weeks, months and
years at a time? You become immune to them so after a while you are wasting your money
and your time swallowing all those expensive pills.
It is good to take a break from your supplements for about a week every other month.
Talk to your health coach about what kind of supplements you should be taking.
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Vitamins & Supplements
Supplements
Keep up with supplement safety alerts!
The Food and Drug Administration (FDA) keeps a list of dietary supplements that are under
regulatory review or that have been reported to cause adverse effects. If you're taking a
supplement, it's a good idea to check the FDA website periodically for updates.
The dietary guidelines for Americans make it clear that your nutritional needs should be met
primarily through your diet. For some people, however, supplements may be a useful way to get
nutrients they might otherwise be lacking. Before you go shopping for supplements, get the facts
on what they will and won't do for you.
Supplements vs. Whole Foods
Supplements aren't intended to be a food substitute because they can't replicate all of the
nutrients and benefits of whole foods, such as fruits and vegetables. So depending on your
situation and your eating habits, dietary supplements may not be worth the expense.
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Vitamins & Supplements
Supplements
Whole foods offer three main benefits over dietary supplements:
Greater nutrition: Whole foods are complex, containing a variety of the micronutrients your
body needs. An orange, for example, provides Vitamin C plus beta carotene, calcium and other
nutrients. A Vitamin C supplement lacks these other micronutrients.
Essential fiber: Whole foods, such as whole grains, fruits, vegetables and legumes, provide
dietary fiber. Most high-fiber foods are also packed with other essential nutrients. Fiber, as part
of a healthy diet, can help prevent certain diseases, such as type 2 diabetes and heart disease,
and it can also help manage constipation.
Protective substances: Whole foods contain other substances important for good health.
Fruits and vegetables, for example, contain naturally occurring substances called
phytochemicals, which may help protect against cancer, heart disease, diabetes and high blood
pressure. Many are also good sources of antioxidants, substances that slow down oxidation, a
natural process that leads to cell and tissue damage.
MayoClinic
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Vitamins & Supplements
Supplements
Who needs supplements?
If you're generally healthy and eat a wide variety of foods, including fruits, vegetables, whole
grains, legumes, low-fat dairy products, lean meats and fish, you likely don't need
supplements. However, the dietary guidelines recommend supplements, or fortified foods, in
the following situations:
 Women who may become pregnant should get 400 micrograms a day of folic acid from
fortified foods or supplements, in addition to eating foods that naturally contain folate.
 Women who are pregnant should take a prenatal vitamin that includes iron or a separate
iron supplement.
 Adults aged 50 or older should eat foods fortified with Vitamin B-12, such as fortified
cereals, or take a multivitamin that contains B-12 or a separate B-12 supplement.
MayoClinic
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Vitamins & Supplements
Supplements
Dietary supplements also may be appropriate if you:
 Don't eat well or consume less than 1,600 calories a day
 Are a vegan or a vegetarian who eats a limited variety of foods
 Are a woman who experiences heavy bleeding during your menstrual period
 Have a medical condition that affects how your body absorbs or uses nutrients, such as
chronic diarrhea, food allergies, food intolerance or a disease of the liver, gallbladder,
intestines or pancreas
 Have had surgery on your digestive tract and are not able to digest and absorb nutrients
properly
MayoClinic
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Vitamins & Supplements
Supplements
Choosing and using supplements:
If you decide to take a vitamin or mineral supplement, consider these factors:
1. Check the label. Read labels carefully. Product labels can tell you what the active ingredient
or ingredients are, which nutrients are included, the serving size (e.g. capsule, packet or tsp)
and the amount of nutrients in each serving.
2. Avoid megadoses. In general, choose a multivitamin-mineral supplement that provides
about 100% of the Daily Value (DV) of all the vitamins and minerals, rather than one which
has, for example, 500% of the DV for one vitamin and only 20% of the DV for another.
3. Check expiration dates. Dietary supplements can lose potency over time, especially in hot
and humid climates. If a supplement doesn't have an expiration date, don't buy it. If your
supplements have expired, discard them.
4. Watch what you eat. Vitamins and minerals are being added to a growing number of foods,
including breakfast cereals and beverages. If you're also taking supplements, you may be
getting more of certain nutrients than you realize. Taking more than you need is expensive
and can raise your risk of side effects. For example, too much iron can cause nausea and
vomiting and may damage the liver and other organs.
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Vitamins & Supplements
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. It 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.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin A
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. Trying to
reach 100% of the DV each day, on average, is useful to help you get enough vitamin A.
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.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
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:
 Beef liver and other organ meats (limit the amount you eat as they are high in cholesterol).
 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
 Fortified breakfast cereals.
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.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin A
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, the inability to see in low light, which can lead to
blindness if it isn't treated.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin A
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 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 get measles, the disease tends to be severe. Taking
supplements with high doses of vitamin A can shorten the duration of the fever and diarrhea.
They can also lower the risk of death in children with measles living in developing countries
where this deficiency is common.
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National Institutes of Health
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Vitamins & Supplements
Vitamin A
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 yelloworange, 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 here. 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.
Office of Dietary Supplements –
National Institutes of Health
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
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Vitamins & Supplements
Vitamin A
Food
mcg RAE
per
serving
127–149
IU per
serving
Percent
Daily Value
500
10
149
500
10
13
274
5
Egg, hard boiled, 1 large
75
260
5
Summer squash, all varieties, boiled, ½ cup
10
191
4
Salmon, sockeye, cooked, 3 ounces
59
176
4
Yogurt, plain, low fat, 1 cup
32
116
2
Pistachio nuts, dry roasted, 1 ounce
4
73
1
Tuna, light, canned in oil, drained solids, 3 ounces
20
65
1
Chicken, breast meat and skin, roasted, ½ breast
5
18
0
Ready-to-eat cereal, fortified with 10% of the daily
value for vitamin A, ¾–1 cup (more heavily fortified
cereals might provide more of the daily value)
Milk, fat-free or skim, with added vitamin A and vitamin
D, 1 cup
Baked beans, canned, plain or vegetarian, 1 cup
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin A
Food
IU per
serving
Percent
Daily Value
Sweet potato, baked in skin, 1 whole
Beef liver, pan fried, 3 ounces
Spinach, frozen, boiled, ½ cup
Carrots, raw, ½ cup
Pumpkin pie, commercially prepared, 1 piece
Cantaloupe, raw, ½ cup
Peppers, sweet, red, raw, ½ cup
Mangos, raw, 1 whole
mcg RAE
per
serving
1,403
6,582
573
459
488
135
117
112
28,058
22,175
11,458
9,189
3,743
2,706
2,332
2,240
561
444
229
184
249
54
47
45
Black-eyed peas (cowpeas), boiled, 1 cup
Apricots, dried, sulfured, 10 halves
Broccoli, boiled, ½ cup
Ice cream, French vanilla, soft serve, 1 cup
Cheese, ricotta, part skim, 1 cup
Tomato juice, canned, ¾ cup
Herring, Atlantic, pickled, 3 ounces
66
63
60
278
263
42
219
1,305
1,261
1,208
1,014
945
821
731
26
25
24
20
19
16
15
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin B12
What is vitamin B12 and what does it do?
Vitamin B12 is a nutrient that helps keep the body's nerve and blood cells healthy and helps
make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia
called megaloblastic anemia that makes people tired and weak.
Two steps are required for the body to absorb vitamin B12 from food. First, hydrochloric acid in
the stomach separates vitamin B12 from the protein to which vitamin B12 is attached in food.
After this, vitamin B12 combines with a protein made by the stomach called intrinsic factor and is
absorbed by the body. Some people have pernicious anemia, a condition where they cannot
make intrinsic factor. As a result, they have trouble absorbing vitamin B12 from all foods and
dietary supplements.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin B12
How much vitamin B12 do I need?
The amount of vitamin B12 you need each day depends on your age. Average daily
recommended amounts for different ages are listed here (in micrograms (mcg).
Life Stage
Recommended
Amount
Birth to 6 months
0.4 mcg
Infants 7–12 months
0.5 mcg
Children 1–3 years
0.9 mcg
Children 4–8 years
1.2 mcg
Children 9–13 years
1.8 mcg
Teens 14–18 years
2.4 mcg
Adults
2.4 mcg
Pregnant teens and
women
2.6 mcg
Breastfeeding teens
and women
2.8 mcg
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin B12
What foods provide vitamin B12?
Vitamin B12 is found naturally in a wide variety of animal foods and is added to some fortified
foods. Plant foods have no vitamin B12 unless they are fortified. You can get recommended
amounts of vitamin B12 by eating a variety of foods including the following:
 Beef liver and clams (the best sources of vitamin B12).
 Fish, meat, poultry, eggs, milk and other dairy products.
 Some breakfast cereals, nutritional yeasts and other food products that are fortified with
vitamin B12. To find out if vitamin B12 has been added to a food product, check the product
labels.
What kinds of vitamin B12 dietary supplements are available?
Vitamin B12 is found in almost all multivitamins. Dietary supplements that contain only vitamin
B12, or vitamin B12 with nutrients such as folic acid and other B vitamins, are also available.
Check the Supplement Facts label to determine the amount of vitamin B12 provided.
Vitamin B12 is also available in sublingual forms (dissolved under the tongue). A prescription form
of vitamin B12 can be administered as a shot. This is usually used to treat vitamin B12 deficiency.
Vitamin B12 is also available as a prescription medication nasal gel form (for use in the nose).
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin B12
Am I getting enough vitamin B12?
Most people in the United States get enough vitamin B12 from the foods they eat. But some
people have trouble absorbing vitamin B12 from food. As a result, vitamin B12 deficiency affects
between 1.5% and 15% of the public. Your doctor can test your vitamin B12 level to see if you
have a deficiency. Certain groups may not get enough vitamin B12 or have trouble absorbing it:
 Older adults, who do not have enough hydrochloric acid in their stomach to absorb the
vitamin B12 naturally present in food. People over 50 should get most of their vitamin B12
from fortified foods or dietary supplements because, in most cases, their bodies can absorb
vitamin B12 from these sources.
 People with pernicious anemia whose bodies do not make the intrinsic factor needed to
absorb vitamin B12. Doctors usually treat pernicious anemia with vitamin B12 shots, although
very high oral doses of vitamin B12 might also be effective.
 People who have had gastrointestinal surgery, such as weight loss surgery, or who have
digestive disorders, such as celiac disease or Crohn's disease. These conditions can
decrease the amount of vitamin B12 that the body can absorb.
 Some people who eat little or no animal foods such as vegetarians and vegans. Only animal
foods have vitamin B12 naturally. When pregnant women and women who breastfeed their
babies are strict vegetarians or vegans, their babies might also not get enough vitamin B12.
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National Institutes of Health
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Vitamins & Supplements
Vitamin B12
What happens if I don't get enough vitamin B12?
Vitamin B12 deficiency causes tiredness, weakness, constipation, loss of appetite, weight loss and
megaloblastic anemia. Nerve problems, such as numbness and tingling in the hands and feet, can
also occur. Other symptoms of vitamin B12 deficiency include problems with balance, depression,
confusion, dementia, poor memory and soreness of the mouth or tongue. Vitamin B12 deficiency
can damage the nervous system even in people who don't have anemia, so it is important to treat
a deficiency as soon as possible.
In infants, signs of a vitamin B12 deficiency include failure to thrive, problems with movement,
delays in reaching the typical developmental milestones and megaloblastic anemia.
Large amounts of folic acid can hide a vitamin B12 deficiency by correcting megaloblastic anemia,
a hallmark of vitamin B12 deficiency. But folic acid does not correct the progressive damage to the
nervous system that vitamin B12 deficiency also causes. For this reason, healthy adults should not
get more than 1,000 mcg of folic acid a day.
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National Institutes of Health
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Vitamins & Supplements
Vitamin B12
What are some effects of vitamin B12 on health?
Scientists are studying vitamin B12 to understand how it affects health. Here are several
examples of what this research has shown:
 Heart disease
Vitamin B12 supplements (along with folic acid and vitamin B6) do not reduce the risk of
getting heart disease. Scientists had thought that these vitamins might be helpful because
they reduce blood levels of homocysteine, a compound linked to an increased risk of having a
heart attack or stroke.
 Dementia
As they get older, some people develop dementia. These people often have high levels of
homocysteine in the blood. Vitamin B12 (with folic acid and vitamin B6) can lower
homocysteine levels, but scientists don't know yet whether these vitamins actually help
prevent or treat dementia.
 Energy and athletic performance
Advertisements often promote vitamin B12 supplements as a way to increase energy or
endurance. Except in people with a vitamin B12 deficiency, no evidence shows that vitamin
B12 supplements increase energy or improve athletic performance.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin B12
Food
Clams, cooked, 3 ounces
Micrograms (mcg) Percent Daily
per serving
Value
84.1
1,402
Liver, beef, cooked, 3 ounces
70.7
1,178
Breakfast cereals, fortified with 100% of the daily value for vitamin B12, 1 serving
6.0
100
Trout, rainbow, wild, cooked, 3 ounces
5.4
90
Salmon, sockeye, cooked, 3 ounces
4.8
80
Trout, rainbow, farmed, cooked, 3 ounces
3.5
58
Tuna fish, light, canned in water, 3 ounces
2.5
42
Cheeseburger, double patty and bun, 1 sandwich
2.1
35
Haddock, cooked, 3 ounces
1.8
30
Breakfast cereals, fortified with 25% of the daily value for vitamin B12, 1 serving
1.5
25
Beef, top sirloin, broiled, 3 ounces
1.4
23
Milk, low-fat, 1 cup
1.2
18
Yogurt, fruit, low-fat, 8 ounces
1.1
18
Cheese, Swiss, 1 ounce
0.9
15
Beef taco, 1 soft taco
0.9
15
Ham, cured, roasted, 3 ounces
0.6
10
Egg, whole, hard boiled, 1 large
0.6
10
Chicken, breast meat, roasted, 3 ounces
0.3
5
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National Institutes of Health
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Vitamins & Supplements
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 here in milligrams (mg).
Office of Dietary Supplements –
National Institutes of Health
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
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Vitamins & Supplements
Vitamin B6
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.
 Potatoes and other starchy vegetables.
 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.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin B6
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.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Vitamin B6
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.
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Vitamins & Supplements
Vitamin B6


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.
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Vitamins & Supplements
Vitamin B6
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
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Vitamins & Supplements
Vitamin B6
Food
Milligrams (mg) per
serving
Chickpeas, canned, 1 cup
1.1
Beef liver, pan fried, 3 ounces
0.9
Tuna, yellow fin, fresh, cooked, 3 ounces
0.9
Salmon, sockeye, cooked, 3 ounces
0.6
Chicken breast, roasted, 3 ounces
0.5
Breakfast cereals, fortified with 25% of the daily value for vitamin 0.5
B6
Potatoes, boiled, 1 cup
0.4
Turkey, meat only, roasted, 3 ounces
0.4
Banana, 1 medium
0.4
Marinara (spaghetti) sauce, ready to serve, 1 cup
0.4
Ground beef, patty, 85% lean, broiled, 3 ounces
0.3
Waffles, plain, ready to heat, toasted, 1 waffle
0.3
Bulgur, cooked, 1 cup
0.2
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Percent
Daily Value
55
45
45
30
25
25
20
20
20
20
15
15
10
34
Vitamins & Supplements
Vitamin B6
Food
Cottage cheese, 1% low-fat, 1 cup
Squash, winter, baked, ½ cup
Rice, white, long-grain, enriched, cooked, 1 cup
Nuts, mixed, dry-roasted, 1 ounce
Raisins, seedless, ½ cup
Onions, chopped, ½ cup
Spinach, frozen, chopped, boiled, ½ cup
Tofu, raw, firm, prepared with calcium sulfate, ½ cup
Watermelon, raw, 1 cup
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Milligrams (mg) per
serving
0.2
0.2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
Percent
Daily Value
10
10
5
5
5
5
5
5
5
35
Vitamins & Supplements
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 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 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.
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Vitamin C
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 here in milligrams (mg).
If you smoke, add 35 mg to the values to
calculate your total daily recommended amount.
Office of Dietary Supplements –
National Institutes of Health
Life Stages
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
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Vitamins & Supplements
Vitamin C
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 red and green
pepper and kiwifruit.
 Other fruits and vegetables such as broccoli, strawberries, cantaloupe, baked potatoes and
tomatoes.
 Some foods and beverages that are fortified with vitamin C. To find out if vitamin C has been
added to a food product, check the product labels.
The vitamin C content of food may be reduced by prolonged storage and by cooking. Steaming or
microwaving may lessen cooking losses. Fortunately, many of the best food sources of vitamin C,
such as fruits and vegetables, are usually eaten raw.
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Vitamin C
What kinds of vitamin C dietary supplements are available?
Most multivitamins have vitamin C. It 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.
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Vitamin C
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 exposed to secondhand smoke (smoke increases the amount of
vitamin C that the body needs to repair damage caused by free radicals). 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 with certain medical conditions such as severe malabsorption, some types of cancer and
kidney disease requiring hemodialysis.
 People who eat a very limited variety of food.
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 depression as 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.
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Vitamin C
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.
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Vitamin C


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 damage is 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.
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.
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Vitamin C

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.
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Vitamin C
Can vitamin C be harmful?
Taking too much vitamin C can cause diarrhea, nausea, and stomach cramps. In people with a
condition called hemochromatosis, 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
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Vitamin C
Food
Milligrams (mg) per serving
Percent Daily Value
Red pepper, sweet, raw, ½ cup
95
158
Orange juice, ¾ cup
93
155
Orange, 1 medium
70
117
Grapefruit juice, ¾ cup
70
117
Kiwifruit, 1 medium
64
107
Green pepper, sweet, raw, ½ cup
60
100
Broccoli, cooked, ½ cup
51
85
Strawberries, fresh, sliced, ½ cup
49
82
Brussels sprouts, cooked, ½ cup
48
80
Grapefruit, ½ medium
39
65
Broccoli, raw, ½ cup
39
65
Tomato juice, ¾ cup
33
55
Cantaloupe, ½ cup
29
48
Cabbage, cooked, ½ cup
28
47
Cauliflower, raw, ½ cup
26
43
Potato, baked, 1 medium
17
28
Tomato, raw, 1 medium
17
28
Spinach, cooked, ½ cup
9
15
Green peas, frozen, cooked, ½ cup
8
13
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Vitamins & Supplements
Calcium
Calcium is important for optimal bone health throughout your life. Although diet is the best way to
get calcium, calcium supplements may be an option if your diet falls short. Before you consider
calcium supplements, be sure you understand how much calcium you need, the pros and cons of
calcium supplements and which type of supplement to choose.
Benefits of calcium:
Your body needs calcium to build and maintain strong bones. Your heart, muscles and nerves
also need calcium to function properly.
Some studies suggest that calcium, along with vitamin D, may have benefits beyond bone health,
perhaps protecting against cancer, diabetes and high blood pressure. But evidence about such
health benefits is not definitive.
Risks of too little calcium:
If you don't get enough calcium, you could face health problems related to weak bones:

Children may not reach their full potential adult height.

Adults may have low bone mass, which is a risk factor for osteoporosis.
Many Americans don't get enough calcium in their diets. Children and adolescent girls are at
particular risk, but so are adults age 50 and older.
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Calcium
Calcium requirements:
How much calcium you need depends on your age and sex. Note that the upper limit in the chart
represents the safe boundary, it's not how much you should aim to get. If you exceed the upper
limit, you may increase your risk of health problems related to excessive calcium.
Calcium: Recommended Dietary Allowance (RDA) for adults
Men
Daily RDA
Daily Upper Limit
19-50 years
1,000 mg
2,500 mg
51-70 years
1,000 mg
2,000 mg
71 and older
1,200 mg
2,000 mg
Women
Daily RDA
Daily Upper Limit
19-50 years
1,000 mg
2,500 mg
51 and older
1,200 mg
2,000 mg
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Calcium
Calcium and vitamin D
Your body needs vitamin D to absorb calcium. For this reason, some calcium supplements contain
vitamin D. A few foods naturally contain small amounts of vitamin D, such as canned salmon with
bones, and egg yolks. You can also get vitamin D from fortified foods and sun exposure. The RDA
for vitamin D is 600 international units (15 micrograms) a day for most adults.
Calcium and diet
Your body doesn't produce calcium, so you must get it through other sources. Calcium can be found
in a variety of foods, including:

Dairy products, such as cheese, milk and yogurt

Dark green leafy vegetables, such as broccoli and kale

Fish with edible soft bones, such as sardines and canned salmon

Calcium-fortified foods and beverages, such as soy products, cereal and fruit juices
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Calcium
Even if you eat a healthy, balanced diet, you may find it difficult to get enough calcium if you:

Follow a vegan diet.

Have lactose intolerance and limit dairy products.

Consume large amounts of protein or sodium, which can cause your body to excrete calcium

Have osteoporosis.

Are receiving long-term treatment with corticosteroids.

Have certain bowel or digestive diseases that decrease your ability to absorb calcium, such
as inflammatory bowel disease or celiac disease.
In these situations, calcium supplements may help you meet your calcium requirements.
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Calcium
Types of calcium supplements:
Several different kinds of calcium compounds are used in calcium supplements. Each compound
contains varying amounts of the mineral calcium, referred to as elemental calcium. Common
calcium supplements may be labeled as:
 Calcium carbonate (40 percent elemental calcium)
 Calcium citrate (21 percent elemental calcium)
 Calcium gluconate (9 percent elemental calcium)
 Calcium lactate (13 percent elemental calcium)
The two main forms of calcium supplements are carbonate and citrate. Calcium carbonate is
cheapest and therefore often a good first choice. Other forms of calcium in supplements include
gluconate and lactate.
In addition, some calcium supplements are combined with vitamins and other minerals. For
instance, some calcium supplements may also contain vitamin D or magnesium. Check the
ingredient list to see which form of calcium your calcium supplement is and what other nutrients it
may contain. This information is important if you have any health or dietary concerns.
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Calcium
Choosing calcium supplements:
To determine which calcium supplement may be best for you, consider these factors:
 Amount of calcium
Elemental calcium is key because it's the actual amount of calcium in the supplement. It's
what your body absorbs for bone growth and other health benefits. The Supplement Facts
label on calcium supplements is helpful in determining how much calcium is in one serving.
As an example, calcium carbonate is 40 percent elemental calcium, so 1,250 milligrams (mg)
of calcium carbonate contains 500 mg of elemental calcium. Be sure to note the serving size
(number of tablets) when determining how much calcium is in one serving.

Tolerability
Calcium supplements cause few, if any, side effects. But side effects can sometimes occur,
including gas, constipation and bloating. In general, calcium carbonate is the most
constipating. You may need to try a few different brands or types of calcium supplements to
find one that you tolerate the best.

Supplement form
Calcium supplements are available in a variety of forms, including tablets, capsules, chews,
liquids and powders. If you have trouble swallowing pills, you may want a chewable or liquid
calcium supplement.
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Vitamins & Supplements
Calcium



What prescriptions you take
Calcium supplements can interact with many different prescription medications, including
blood pressure medications, synthetic thyroid hormones, bisphosphonates, antibiotics and
calcium channel blockers. Ask your doctor or pharmacist about possible interactions and
which type of calcium supplement would work for you.
Quality and cost
Manufacturers are responsible for ensuring that supplements are safe and claims are truthful.
Some companies may have their products independently tested by the U.S.
Pharmacopeia(USP) or Consumer Labs (CL). Supplements that bear the USP or CL
abbreviation meet voluntary industry standards for quality, purity, potency, and tablet
disintegration or dissolution. Different types of calcium supplements have different costs.
Comparison shop if cost is a factor for you.
Absorbability
Your body must be able to absorb the calcium for it to be effective. All varieties of calcium
supplements are better absorbed when taken in small doses (500 mg or less) at mealtimes.
Calcium citrate is absorbed equally well when taken with or without food and is a form
recommended for individuals with low stomach acid (more common in individuals 50 and
older, or if taking stomach acid blockers), inflammatory bowel disease or absorption
disorders.
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Calcium
Do calcium supplements have risks?
Calcium supplements aren't for everyone. For instance, if you have a health condition that causes
excess calcium in your bloodstream (hypercalcemia), you should avoid calcium supplements. If
you aren't sure if calcium supplements are appropriate for your situation, talk to your doctor.
It's not definitive, but there may be a link between calcium supplements and heart disease. It's
thought that the calcium in supplements could make its way into fatty plaques in your arteries, a
condition called atherosclerosis, causing those plaques to harden and increasing your risk of
heart attack. More research is needed before doctors know the effect calcium supplements may
have on heart attack risk.
There is similar controversy about calcium and prostate cancer. Some studies have shown that
high calcium intake from dairy products and supplements may increase risk whereas another
more recent study showed no increased risk of prostate cancer associated with total calcium,
dietary calcium or supplemental calcium intakes.
As with any health issue, it's important to talk to your doctor to determine what's right for you.
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Calcium
More isn't always better: too much calcium has risks
Dietary calcium is generally safe, but more isn't necessarily better, and excessive calcium doesn't
provide extra bone protection. In fact, if the calcium in your diet and from supplements exceeds
the tolerable upper limit, you could increase your risk of health problems, such as: kidney stones,
prostate cancer, constipation, calcium buildup in your blood vessels and impaired absorption of
iron and zinc
If you take calcium supplements and eat calcium-fortified foods, you may be getting more calcium
than you realize. Check food and supplement labels to monitor how much calcium you're getting
a day and whether you're achieving the RDA but not exceeding the recommended upper limit.
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Vitamins & Supplements
Vitamin D
What is vitamin D and what does it do?
Vitamin D is a nutrient found in some foods that is needed for health and to maintain strong
bones. It does so by helping the body absorb calcium (one of bone's main building blocks) from
food and supplements. People who get too little vitamin D may develop soft, thin and brittle
bones, a condition known as rickets in children and osteomalacia in adults.
Vitamin D is important to the body in many other ways as well. Muscles need it to move, for
example, nerves need it to carry messages between the brain and every body part and the
immune system needs vitamin D to fight off invading bacteria and viruses. Together with calcium,
vitamin D also helps protect older adults from osteoporosis. Vitamin D is found in cells throughout
the body.
How much vitamin D do I need?
The amount of vitamin D you need each day
depends on your age. Average daily
recommended amounts from the Food and
Nutrition Board for different ages are listed
here in International Units (IU):
Office of Dietary Supplements –
National Institutes of Health
Life Stage
Recommended Amount
Birth to 12 months
400 IU
Children 1–13 years
600 IU
Teens 14–18 years
600 IU
Adults 19–70 years
600 IU
Adults 71 years and older
800 IU
Pregnant and breastfeeding women
600 IU
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Vitamin D
What foods provide vitamin D?
Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American
diets.
 Fatty fish such as salmon, tuna and mackerel are among the best sources.
 Beef liver, cheese and egg yolks provide small amounts.
 Mushrooms provide some vitamin D. In some mushrooms that are newly available in stores,
the vitamin D content is being boosted by exposing these mushrooms to ultraviolet light.
 Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart. But foods
made from milk, like cheese and ice cream, are usually not fortified.
 Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt,
margarine and soy beverages; check the labels.
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Vitamins & Supplements
Vitamin D
Can I get vitamin D from the sun?
The body makes vitamin D when skin is directly exposed to the sun and most people meet at least
some of their vitamin D needs this way. Skin exposed to sunshine indoors through a window
will not produce vitamin D. Cloudy days, shade and having dark-colored skin also cut down on
the amount of vitamin D the skin makes.
However, despite the importance of the sun to vitamin D synthesis, it is prudent to limit exposure
of skin to sunlight in order to lower the risk for skin cancer. When out in the sun for more than a
few minutes, wear protective clothing and apply sunscreen with an SPF (sun protection factor) of
8 or more. Tanning beds also cause the skin to make vitamin D, but pose similar risks for skin
cancer.
People who avoid the sun or who cover their bodies with sunscreen or clothing should include
good sources of vitamin D in their diets or take a supplement. Recommended intakes of vitamin D
are set on the assumption of little sun exposure.
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Vitamins & Supplements
Vitamin D
What kinds of vitamin D dietary supplements are available?
Vitamin D is found in supplements (and fortified foods) in two different forms: D2 (ergocalciferol)
and D3(cholecalciferol). Both increase vitamin D in the blood.
Am I getting enough vitamin D?
Because vitamin D can come from sun, food and supplements, the best measure of one's vitamin
D status is blood levels of a form known as 25-hydroxyvitamin D. Levels are described in either
nanomoles per liter (nmol/L) or nanograms per milliliter (ng/mL), where 1 nmol/L = 0.4 ng/mL. In
general, levels below 30 nmol/L (12 ng/mL) are too low for bone or overall health, and levels
above 125 nmol/L (50 ng/mL) are probably too high. Levels of 50 nmol/L or above (20 ng/mL or
above) are sufficient for most people.
By these measures, some Americans are vitamin D deficient and almost no one has levels that are
too high. In general, young people have higher blood levels of 25-hydroxyvitamin D than older
people and males have higher levels than females. By race, non-Hispanic blacks tend to have the
lowest levels and non-Hispanic whites the highest. The majority of Americans have blood levels
lower than 75 nmol/L (30 ng/mL).
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Vitamins & Supplements
Vitamin D
Certain other groups may not get enough vitamin D:
 Breastfed infants, since human milk is a poor source of the nutrient. Breastfed infants should
be given a supplement of 400 IU of vitamin D each day.
 Older adults, since their skin doesn't make vitamin D when exposed to sunlight as efficiently
as when they were young and their kidneys are less able to convert vitamin D to its active
form.
 People with dark skin, because their skin has less ability to produce vitamin D from the sun.
 People with disorders such as Crohn's disease or celiac disease who don't handle fat
properly, because vitamin D needs fat to be absorbed.
 Obese people, because their body fat binds to some vitamin D and prevents it from getting
into the blood.
What happens if I don't get enough vitamin D?
People can become deficient in vitamin D because they don't consume or absorb enough from
food, their exposure to sunlight is limited, or their kidneys cannot convert vitamin D to its active
form in the body. In children, vitamin D deficiency causes rickets, where the bones become soft
and bend. It's a rare disease but still occurs, especially among African American infants and
children.
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Vitamins & Supplements
Vitamin D
What are some effects of vitamin D on health?
Vitamin D is being studied for its possible connections to several diseases and medical problems,
including diabetes, hypertension, and autoimmune conditions such as multiple sclerosis. Two of
them discussed below are bone disorders and some types of cancer.
 Bone disorders
As they get older, millions of people (mostly women, but men too) develop, or are at risk of,
osteoporosis, where bones become fragile and may fracture if one falls. It is one consequence
of not getting enough calcium and vitamin D over the long term. Supplements of both vitamin
D3 (at 700–800 IU/day) and calcium (500–1,200 mg/day) have been shown to reduce the risk
of bone loss and fractures in elderly people aged 62–85 years. Men and women should talk
with their health care providers about their needs for vitamin D (and calcium) as part of an
overall plan to prevent or treat osteoporosis.

Cancer
Some studies suggest that vitamin D may protect against colon cancer and perhaps even
cancers of the prostate and breast. But higher levels of vitamin D in the blood have also been
linked to higher rates of pancreatic cancer. At this time, it's too early to say whether low vitamin
D status increases cancer risk and whether higher levels protect or even increase risk in some
people.
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Vitamin D
Can vitamin D be harmful?
Yes, when amounts in the blood become too high, it can lead to toxicity. Signs of toxicity include
 nausea
 vomiting
 poor appetite
 constipation
 weakness
 weight loss
By raising blood levels of calcium, too much vitamin D can cause confusion, disorientation and
problems with heart rhythm. Excess vitamin D can also damage the kidneys.
The safe upper limit for vitamin D is 1,000 to 1,500 IU/day for infants, 2,500 to 3,000 IU/day for
children 1-8 years, and 4,000 IU/day for children 9 years and older, adults and pregnant and
lactating teens and women. Vitamin D toxicity almost always occurs from overuse of
supplements. Excessive sun exposure doesn't cause vitamin D poisoning because the body limits
the amount of this vitamin it produces.
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Vitamins & Supplements
Vitamin D
Food
IUs per serving
Percent Daily
Value
Cod liver oil, 1 tablespoon
1,360
340
Swordfish, cooked, 3 ounces
566
142
Salmon (sockeye), cooked, 3 ounces
447
112
Tuna fish, canned in water, drained, 3 ounces
154
39
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of
added vitamin D varies)
137
34
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup
115-124
29-31
Yogurt, fortified with 20% of the daily value for vitamin D, 6 ounces (more heavily 80
fortified yogurts provide more of the daily value)
20
Margarine, fortified, 1 tablespoon
60
15
Sardines, canned in oil, drained, 2 sardines
46
12
Liver, beef, cooked, 3 ounces
42
11
Egg, 1 large (vitamin D is found in yolk)
41
10
Ready-to-eat cereal, fortified with 10% of the daily value for vitamin D, 0.75-1
cup (more heavily fortified cereals might provide more of the daily value)
Cheese, Swiss, 1 ounce
40
10
6
2
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Vitamins & Supplements
Vitamin D
Getting the vitamin D your body needs:
The two main ways to get vitamin D are by exposing your bare skin to sunlight and by taking
vitamin D supplements. You can’t get the right amount of vitamin D your body needs from food.
Exposing your body to sunlight:
Your body is designed to get the vitamin D it needs by producing it when your bare skin is
exposed to sunlight. The part of the sun’s rays that is important is ultraviolet B (UVB). This is the
most natural way to get vitamin D.
Large amounts of vitamin D3 (cholecalciferol) are made in your skin when you expose all of your
body to summer sun. This happens very quickly; around half the time it takes for your skin to turn
pink and begin to burn. This could be just 15 minutes for a very fair skinned person or a couple of
hours or more for a dark skinned person.
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Vitamin D
You don’t need to tan or to burn your skin in order to get the vitamin D you need. Exposing your
skin for a short time will make all the vitamin D your body can produce in one day. In fact, your body
can produce 10,000 to 25,000 IU of vitamin D in just a little under the time it takes for your skin to
turn pink. You make the most vitamin D when you expose a large area of your skin, such as your
back, rather than a small area such as your face or arms.
There are a number of factors that affect how much vitamin D your body produces when your skin
is exposed to sunlight.
The amount of vitamin D you get from exposing your bare skin to the sun depends on:
 The time of day – more vitamin D is produced if your skin is exposed during the middle of the
day.

Where you live – the closer to the equator you live, the easier it is for you to produce vitamin
D from sunlight all year round.


The color of your skin – pale skins make vitamin D more quickly than darker skins.
The amount of skin you expose – the more skin your expose the more vitamin D your body
will produce.
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Vitamins & Supplements
Vitamin D
Exposing your skin to UVB and risk of cancer:
Exposing your skin to the sun for too long, so that your skin starts to burn can be dangerous. This
is because it can increase your risk of developing skin cancers. Research to date shows that
moderate but frequent sun exposure is healthy but overexposure and intense exposure can
increase your risk of skin cancer.
After you have exposed your skin for half the time it takes for you to turn pink, cover up with
clothing and go into the shade. Using sunscreen is not as recommended as using shade and
clothing to protect your skin, because it hasn’t consistently been shown to prevent all types of skin
cancers. But if you do want to use sunscreen, use a sunscreen that blocks both UVA light and UVB
light.
Vitamin D supplements:
In the 21st century, it’s hard to get daily full body sun exposure. On the days that you can’t get
enough sun exposure, taking a supplement is an effective way to get the vitamin D your body
needs. It‘s also a good way to get vitamin D if you’re worried about exposing your skin to the sun.
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Vitamin D
How much vitamin D do I need to take?
Different organizations recommend different daily intakes. Here are the recommendations from
some organizations in the United States:
Recommended daily intakes from various organizations:
Vitamin D Council
Endocrine Society
Food and Nutrition Board
Infants
1,000 IU/day
400-1,000 IU/day
400 IU/day
Children
1,000 IU/day per 25lbs of body weight
600-1,000 IU/day
600 IU/day
Adults
5,000 IU/day
1,500-2,000 IU/day
600 IU/day, 800 IU/day for seniors
The Food and Nutrition Board recommended daily intakes are the official recommendations by
the United States government.
Why are the recommendations so different? Some researchers believe that there isn’t enough
evidence to support taking higher amounts of vitamin D yet. On the other hand, some researchers
believe that research is proving, or will prove, that taking lower amounts isn’t enough.
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Vitamin D
Types and usage of vitamin D:
The Vitamin D Council recommends taking vitamin D3 rather than vitamin D2. Vitamin D3 is the
type of vitamin D your body produces in response to sun exposure, while vitamin D2 is not. In the
United States, most over-the-counter vitamin D supplements are D3, but check to make sure.
Vitamin D2 is sometimes prescribed by doctors because that is what pharmacies have available.
If your doctor prescribes you D2, ask them if you can take vitamin D3 instead.
Vitamin D3 supplements aren’t vegetarian and some part of the production in making them occur
outside the United States. If you have ethical concerns with taking vitamin D3, then sun exposure
is a good option and vitamin D2 can be an alternative.
Other than that, it doesn’t matter what form of vitamin D you take, whether it’s in a capsule, tablet
or liquid drop. For most people, vitamin D is easily absorbed in the body and you don’t need to
worry about what time of day you take it or whether you take it with meals.
Cod liver oil contains vitamin D. However, the Vitamin D Council recommends against it because
it has a high amount of vitamin A. Vitamin A is also a fat-soluble vitamin, so your body has a hard
time getting rid of it and too much vitamin A can be harmful.
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Vitamin D
Can anyone take vitamin D supplements?
Most people can take vitamin D supplements with no problems. However, care is needed in a few
situations. These situations include:
 If you’re taking certain other medicines: digoxin for an irregular heartbeat (atrial fibrillation) or
thiazide diuretics such as hydrochlorothiazide or bendroflumethiazide (commonly used to
treat high blood pressure). In this situation, don’t take high doses of vitamin D. You should
also have your digoxin level monitored more closely if you’re taking vitamin D.
 If you have one of these medical conditions: primary hyperparathyroidism, Hodgkin’s or nonHodgkin’s lymphoma, a granulomatous disease, kidney stones, some types of kidney
disease, liver disease or hormonal disease, you should get advice from a specialist.
 Don’t take vitamin D if you have high blood calcium levels, unless under the care of your
physician.
 You may need more than the usual dose of vitamin D if you’re taking certain medicines which
interfere with vitamin D. These include carbamazepine, phenytoin, primidone, barbiturates
and some medicines used for the treatment of HIV infection.
Vitamin D Council
-Source: Vitamin D Council
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Vitamin D
Vitamin D and diet:
There are small amounts of vitamin D in a few foods, which makes it nearly impossible to get
what you need from food. However, these foods include:
 Fatty fish
 Beef liver
 Egg yolks
 Fortified milk and orange juice
 Fortified cereals
 Infant formula
The Vitamin D Council believes that trying to get enough vitamin D from your diet is unlikely to
give you the vitamin D you need.
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Vitamins & Supplements
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 here in
milligrams (mg) and in International Units (IU).
Package labels list the amount of vitamin E
in foods and dietary supplements in IU.
Office of Dietary Supplements –
National Institutes of Health
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)
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Vitamin E
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. Corn and soybean oils also
provide some vitamin E.
 Nuts (such as peanuts, hazelnuts, and, especially, almonds) and seeds (like sunflower
seeds).
 Green vegetables, such as spinach and broccoli.
Food companies add vitamin E to some breakfast cereals, fruit juices, margarines and spreads
and other foods. To find out which ones have vitamin E, check the product labels.
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Vitamins & Supplements
Vitamin E
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.
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.
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Vitamin E
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.
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Vitamin E
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 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.
 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.
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Vitamins & Supplements
Vitamin E


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.
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.
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Vitamins & Supplements
Vitamin E
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.
Recommended Dietary Allowances (RDAs) for Vitamin E
Age
Males
Females
0–6 months*
4 mg (6 IU)
4 mg (6 IU)
7–12 months*
5 mg (7.5 IU)
5 mg (7.5 IU)
1–3 years
6 mg (9 IU)
6 mg (9 IU)
4–8 years
7 mg (10.4 IU)
7 mg (10.4 IU)
9–13 years
11 mg (16.4 IU)
11 mg (16.4 IU)
14+ years
15 mg (22.4 IU)
15 mg (22.4 IU)
Office of Dietary Supplements –
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Pregnancy
Lactation
15 mg (22.4 IU)
19 mg (28.4 IU)
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Vitamins & Supplements
Vitamin E
Food sources of vitamin E
Food
(mg) per serving
Wheat germ oil, 1 tablespoon
Sunflower seeds, dry roasted, 1 ounce
Almonds, dry roasted, 1 ounce
Sunflower oil, 1 tablespoon
Safflower oil, 1 tablespoon
Hazelnuts, dry roasted, 1 ounce
Peanut butter, 2 tablespoons
Peanuts, dry roasted, 1 ounce
Corn oil, 1 tablespoon
Spinach, boiled, ½ cup
Broccoli, chopped, boiled, ½ cup
Soybean oil, 1 tablespoon
Kiwifruit, 1 medium
Mango, sliced, ½ cup
Tomato, raw, 1 medium
Spinach, raw, 1 cup
20.3
7.4
6.8
5.6
4.6
4.3
2.9
2.2
1.9
1.9
1.2
1.1
1.1
0.7
0.7
0.6
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Percent Daily
Value
100
37
34
28
25
22
15
11
10
10
6
6
6
4
4
3
77
Vitamins & Supplements
Folate
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.
How much folate do I need?
The amount of folate you need depends on your age. Average daily recommended amounts are
listed below in micrograms (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+
400 mcg DFE
Pregnant teens and women
600 mcg DFE
Breastfeeding teens and women
500 mcg DFE
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Vitamins & Supplements
Folate
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, brussel sprouts and dark green leafy vegetables such as
spinach and mustard greens).
 Fruits and fruit juices (especially oranges and orange juice).
 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.
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Vitamins & Supplements
Folate
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 in the United States 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.
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Folate
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.
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Vitamins & Supplements
Folate
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. 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.
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.
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Vitamins & Supplements
Folate


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.
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Vitamins & Supplements
Folate


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.
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Vitamins & Supplements
Folate
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 the nerve 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 here.
Office of Dietary Supplements –
National Institutes of Health
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
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Vitamins & Supplements
Folate
Food
mcg DFE per serving
Percent
Daily Value
Beef liver, braised, 3 ounces
Spinach, boiled, ½ cup
Black-eyed peas (cowpeas), boiled, ½ cup
Breakfast cereals, fortified with 25% of the daily value
Rice, white, medium-grain, cooked, ½ cup
Asparagus, boiled, 4 spears
Spaghetti, cooked, enriched, ½ cup
Brussels sprouts, frozen, boiled, ½ cup
Lettuce, romaine, shredded, 1 cup
Avocado, raw, sliced, ½ cup
Spinach, raw, 1 cup
Broccoli, chopped, frozen, cooked, ½ cup
Mustard greens, chopped, frozen, boiled, ½ cup
Green peas, frozen, boiled, ½ cup
Kidney beans, canned, ½ cup
215
131
105
100
90
89
83
78
64
59
58
52
52
47
46
54
33
26
25
23
22
21
20
16
15
15
13
13
12
12
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Folate
Food
mcg DFE per serving Percent Daily
Value
Bread, white, 1 slice
Peanuts, dry roasted, 1 ounce
Wheat germ, 2 tablespoons
Tomato juice, canned, ¾ cup
Crab, Dungeness, 3 ounces
Orange juice, ¾ cup
Turnip greens, frozen, boiled, ½ cup
Orange, fresh, 1 small
Papaya, raw, cubed, ½ cup
Banana, 1 medium
Yeast, baker’s, ¼ teaspoon
Egg, whole, hard-boiled, 1 large
Vegetarian baked beans, canned, ½ cup
Cantaloupe, raw, 1 wedge
Fish, halibut, cooked, 3 ounces
Milk, 1% fat, 1 cup
Ground beef, 85% lean, cooked, 3 ounces
Chicken breast, roasted, ½ breast
43
41
40
36
36
35
32
29
27
24
23
22
15
14
12
12
7
3
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11
10
10
9
9
9
8
7
7
6
6
6
4
4
3
3
2
1
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Iodine
What is iodine and what does it do?
Iodine is a mineral found in some foods. The body needs iodine to make thyroid hormones. These
hormones control the body's metabolism and many other important functions. The body also needs
thyroid hormones for proper bone and brain development during pregnancy and infancy. Getting
enough iodine is important for everyone, especially infants and women who are pregnant.
How much iodine do I need?
The amount of iodine you need each
day depends on your age.
Average daily recommended amounts
are listed here in micrograms (mcg).
Office of Dietary Supplements –
National Institutes of Health
Life Stage
Recommended Amount
Birth to 6 months
110 mcg
Infants 7–12 months
130 mcg
Children 1–8 years
90 mcg
Children 9–13 years
120 mcg
Teens 14–18 years
150 mcg
Adults
150 mcg
Pregnant teens and women
220 mcg
Breastfeeding teens and
women
290 mcg
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Iodine
What foods provide iodine?
Iodine is found naturally in some foods and is also added to salt that is labeled as "iodized". You
can get recommended amounts of iodine by eating a variety of foods, including the following:
 Fish (such as cod and tuna), seaweed, shrimp and other seafood.
 Dairy products (such as milk, yogurt and cheese) and products made from grains (like
breads and cereals).
 Fruits and vegetables, which contain iodine, although the amount depends on the iodine
in the soil where they grew and in any fertilizer that was used.
 Iodized salt. Processed foods, however, such as canned soups, almost never contain
iodized salt.
What kinds of iodine dietary supplements are available?
Iodine is available in dietary supplements, usually in the form of potassium iodide or sodium
iodide. Many multivitamin-mineral supplements contain iodine. Dietary supplements of iodine
containing kelp (a seaweed) are also available.
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Am I getting enough iodine?
Most people in the United States get enough iodine from foods and beverages. However, certain
groups of people are more likely than others to have trouble getting enough iodine:
 People who do not use iodized salt. Adding iodine to salt is the most widely used strategy to
control iodine deficiency. Currently, about 70% of households worldwide use iodized salt.
 Pregnant women. Women who are pregnant need about 50% more iodine than other women
to provide enough iodine for their baby. Surveys show that many pregnant women in the
United States may not get quite enough iodine, although experts do not know whether this
affects their babies.
 People living in regions with iodine-deficient soils who eat mostly local foods. These soils
produce crops that have low iodine levels. Among the regions with the most iodine-poor soil
are mountainous areas, such as the Himalayas, the Alps, and the Andes regions, as well as
river valleys in South and Southeast Asia.
 People who get marginal amounts of iodine and who also eat foods containing goitrogens.
Goitrogens are substances that interfere with the way the body uses iodine. They are present
in some plant foods including soy and cruciferous vegetables such as cabbage, broccoli,
cauliflower and brussel sprouts.
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What happens if I don't get enough iodine?
Iodine deficiency is uncommon in the United States and Canada. People who don't get enough
iodine cannot make sufficient amounts of thyroid hormone. This can cause many problems. In
pregnant women, severe iodine deficiency can permanently harm the fetus by causing stunted
growth, mental retardation and delayed sexual development. Less severe iodine deficiency can
cause lower-than-average IQ in infants and children and decrease adults' ability to work and think
clearly. Goiter, an enlarged thyroid gland, is often the first visible sign of iodine deficiency.
What are some effects of iodine on health?
Scientists are studying iodine to understand how it affects health. Here are some examples of
what this research has shown.
 Fetal and infant development
Women who are pregnant or breastfeeding need to get enough iodine for their babies to grow
and develop properly. Breastfed infants get iodine from breast milk. However, the iodine
content of breast milk depends on how much iodine the mother gets. To make adequate
amounts of iodine available for proper fetal and infant development, several national and
international groups recommend that pregnant and breastfeeding women and infants take
iodine supplements.
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Iodine


Cognitive function during childhood
Severe iodine deficiency during childhood has harmful effects on the development of the brain
and nervous system. The effects of mild iodine deficiency during childhood are more difficult to
measure, but mild iodine deficiency might cause subtle problems with neurological
development.
Giving iodine supplements to children with mild iodine deficiency improves their reasoning
abilities and overall cognitive function. In children living in iodine-deficient areas, iodine
supplements seem to improve both physical and mental development. More study is needed to
fully understand the effects of mild iodine deficiency and of iodine supplements on cognitive
function.
Fibrocystic breast disease
Although not harmful, fibrocystic breast disease causes lumpy, painful breasts. It mainly
affects women of reproductive age but can also occur during menopause. Very high doses of
iodine supplements might reduce the pain and other symptoms of fibrocystic breast disease,
but more study is necessary to confirm this. Check with your health care provider before
taking iodine for this condition, especially because iodine can be unsafe at high doses.
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Iodine

Radiation-induced thyroid cancer
Nuclear accidents can release radioactive iodine into the environment, increasing the risk of
thyroid cancer in people who are exposed to the radioactive iodine, especially children.
People with iodine deficiency who are exposed to radioactive iodine are especially at risk of
developing thyroid cancer. The U.S. Food and Drug Administration has approved potassium
iodide as a thyroid-blocking agent to reduce the risk of thyroid cancer in radiation
emergencies.
Are there any interactions with iodine that I should know about?
Yes, they can interact or interfere with medicines that you take. Here are several examples:
 Iodine supplements might interact with anti-thyroid medications such as methimazole
(Tapazole®). Taking high doses of iodine with anti-thyroid medications could cause your body
to produce too little thyroid hormone.
 Taking potassium iodide with medicines for high blood pressure (ACE inhibitors including
benazepril (Lotensin®), lisinopril (Prinivil® and Zestril®) and fosinopril (Monopril®) could raise
the amount of potassium in your blood to an unsafe level.
 The amount of potassium in your blood can also get too high if you take potassium iodide with
potassium-sparing diuretics such as spironolactone (Aldactone®) and amiloride (Midamor®).
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Can iodine be harmful?
Yes, if you get too much. Getting high levels of iodine can cause some of the same symptoms as
iodine deficiency, including goiter (an enlarged thyroid gland). High iodine intakes can also cause
thyroid gland inflammation and thyroid cancer. Getting a very large dose of iodine (several grams,
for example) can cause burning of the mouth, throat, and stomach, fever, stomach pain, nausea,
vomiting, diarrhea, weak pulse and coma.
The safe upper limits for iodine are listed here.
These levels do not apply to people who are
taking iodine for medical reasons under
the care of a doctor.
Office of Dietary Supplements –
National Institutes of Health
Life Stage
Upper Safe Limit
Birth to 12 months:
Not established
Children 1–3 years:
200 mcg
Children 4–8 years:
300 mcg
Children 9–13 years:
600 mcg
Teens 14–18 years:
900 mcg
Adults:
1,100 mcg
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Iodine
Food
Seaweed, whole or sheet, 1 g
Cod, baked, 3 ounces
Yogurt, plain, low-fat, 1 cup
Iodized salt, 1.5 g (approx. 1/4
teaspoon)
Milk, reduced fat, 1 cup
Fish sticks, 3 ounces
Bread, white, enriched, 2 slices
Fruit cocktail in heavy syrup, canned,
1/2 cup
Shrimp, 3 ounces
Ice cream, chocolate, 1/2 cup
Macaroni, enriched, boiled, 1 cup
Office of Dietary Supplements –
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Approximate Micrograms
(mcg) per serving
16 to 2,984
99
75
71
Percent Daily Value
56
54
45
42
37%
36%
30%
28%
35
30
27
23%
20%
18%
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11% to 1,989%
66%
50%
47%
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Iodine
Food
Egg, 1 large
Tuna, canned in oil, drained, 3
ounces
Corn, cream style, canned, 1/2 cup
Prunes, dried, 5 prunes
Cheese, cheddar, 1 ounce
Raisin bran cereal, 1 cup
Lima beans, mature, boiled, 1/2 cup
Apple juice, 1 cup
Green peas, frozen, boiled, 1/2 cup
Banana, 1 medium
Office of Dietary Supplements –
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Approximate Micrograms Percent Daily Value
(mcg) per serving
24
16%
17
11%
14
13
12
11
8
7
3
3
9%
9%
8%
7%
5%
5%
2%
2%
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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.
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Iron
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.
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Sources of heme iron:
Sources of nonheme iron:
Food
mg
per
serving
% Daily
Value
Food
mg
per serving
Chicken liver, pan-fried, 3 ounces
11.0
61
Ready-to-eat cereal, 100% iron fortified, ¾ cup
18.0
%
Daily
Value
100
Oysters, canned, 3 ounces
5.7
32
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
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
Ready-to-eat cereal, 25% iron fortified, ¾ cup
4.5
25
Beef, top sirloin, steak, lean only, broiled, 3 ounces
1.6
9
Blackeye peas, (cowpeas), mature, boiled, 1 cup
4.3
24
Tuna, light, canned in water, 3 ounces
1.3
7
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
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, yellow fin, cooked, dry heat, 3 ounces
0.8
4
Spinach, canned, drained solids ½ cup
2.5
14
Crab, Alaskan king, cooked, moist heat, 3 ounces
0.7
4
Spinach, frozen, chopped or leaf, boiled ½ cup
1.9
11
Pork, loin chop, broiled, 3 ounces
0.7
4
Raisins, seedless, packed, ½ cup
1.6
9
Shrimp, mixed species, cooked, moist heat, 4 large
0.3
2
Grits, white, enriched, quick, prepared with water, 1 cup
1.5
8
Halibut, cooked, dry heat, 3 ounces
0.2
1
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
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Iron
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.
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What is the recommended intake for iron?
Recommendations for iron are provided in the Dietary Reference Intakes (DRIs) developed by the
Institute of Medicine of the National Academy of Sciences. Dietary Reference Intakes is the
general term for a set of reference values used for planning and assessing nutrient intake for
healthy people.
Three important types of reference values included in the DRIs are Recommended Dietary
Allowances (RDA), Adequate Intakes (AI) and Tolerable Upper Intake Levels (UL). The RDA
recommends the average daily intake that is sufficient to meet the nutrient requirements of nearly
all (97–98%) healthy individuals in each age and gender group. An AI is set when there is
insufficient scientific data available to establish a RDA. AIs meet or exceed the amount needed to
maintain a nutritional state of adequacy in nearly all members of a specific age and gender group.
The UL, on the other hand, is the maximum daily intake unlikely to result in adverse health effects.
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Recommended Dietary Allowances 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
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
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. This negative balance
initially depletes the storage form of iron while the blood hemoglobin level, a marker of iron status,
remains normal. Iron deficiency anemia is an advanced stage of iron depletion. It occurs when
storage sites of iron are deficient and blood levels of iron cannot meet daily needs. Blood
hemoglobin levels are below normal with iron deficiency anemia.
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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.
Individuals with kidney failure, especially those being treated with dialysis, are at high risk for
developing iron deficiency anemia. This is because their kidneys cannot create enough
erythropoietin, a hormone needed to make red blood cells. Both iron and erythropoietin can be lost
during kidney dialysis. Individuals who receive routine dialysis treatments usually need extra iron
and synthetic erythropoietin to prevent 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. While uncommon in the
U.S., this problem is seen in developing countries where vitamin A deficiency often occurs.
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Chronic malabsorption can contribute to iron depletion and deficiency by limiting dietary iron
absorption or by contributing to intestinal blood loss. Most iron is absorbed in the small intestines.
Gastrointestinal disorders that result in inflammation of the small intestine may result in diarrhea,
poor absorption of dietary iron and iron depletion.
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)
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Iron
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. Some researchers believe that these eating abnormalities may result in an iron
deficiency. Other researchers believe that iron deficiency may somehow increase the likelihood of
these eating problems.
People with chronic infectious, inflammatory or malignant disorders such as arthritis and cancer
may become anemic. However, the anemia that occurs with inflammatory disorders differs from
iron deficiency anemia and may not respond to iron supplements. Research suggests that
inflammation may over-activate a protein involved in iron metabolism. This protein may inhibit iron
absorption and reduce the amount of iron circulating in blood, resulting in anemia.
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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
Celiac Disease and Crohn's Syndrome are associated with gastrointestinal malabsorption and may
impair iron absorption. Iron supplementation may be needed if these conditions result in iron
deficiency anemia.
Women taking oral contraceptives may experience less bleeding during their periods and have a
lower risk of developing an iron deficiency. Women who use an intrauterine device (IUD) to prevent
pregnancy may experience more bleeding and have a greater risk of developing an iron deficiency.
If laboratory tests indicate iron deficiency anemia, iron supplements may be recommended.
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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.
There are many causes of anemia, including iron deficiency. There are also several potential
causes of iron deficiency. After a thorough evaluation, physicians can diagnose the cause of
anemia and prescribe the appropriate treatment.
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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. If iron intake does not meet increased requirements, iron deficiency anemia
can occur. Iron deficiency anemia of pregnancy is responsible for significant morbidity, such as
premature deliveries and giving birth to infants with low birth weight.
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. In the U.S., the Centers for Disease
Control (CDC) estimated that 12% of all women age 12 to 49 years were iron deficient in 1999–
2000. When broken down by groups, 10% of non-Hispanic white women, 22% of MexicanAmerican women and 19% of non-Hispanic black women were iron deficient. Prevalence of iron
deficiency anemia among lower income pregnant women has remained the same, at about 30%,
since the 1980s.
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The RDA for iron for pregnant women increases to 27 mg per day. Unfortunately, data from the
1988–94 NHANES survey suggested that the median iron intake among pregnant women was
approximately 15 mg per day. When median iron intake is less than the RDA, more than half of
the group consumes less iron than is recommended each day.
Several major health organizations recommend iron supplementation during pregnancy to help
pregnant women meet their iron requirements. The CDC recommends routine low-dose iron
supplementation (30 mg/day) for all pregnant women, beginning at the first prenatal visit. When a
low hemoglobin or hematocrit is confirmed by repeat testing, the CDC recommends larger doses
of supplemental iron. The Institute of Medicine of the National Academy of Sciences also supports
iron supplementation during pregnancy. Obstetricians often monitor the need for iron
supplementation during pregnancy and provide individualized recommendations to pregnant
women.
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Vitamin K
Vitamin K is a vitamin found in leafy green vegetables, broccoli, and brussel sprouts. The name
vitamin K comes from the German word “Koagulationsvitamin.”
Several forms of vitamin K are used around the world as medicine. But in the U.S., the only form
available is vitamin K1 (phytonadione). Vitamin K1 is generally the preferred form of vitamin K
because it is less toxic, works faster, is stronger, and works better for certain conditions.
In the body, vitamin K plays a major role in blood clotting. It is used to reverse the effects of blood
thinning medications when too much is given; to prevent clotting problems in newborns who don’t
have enough vitamin K; and to treat bleeding caused by medications including salicylates,
sulfonamides, quinine, quinidine or antibiotics. Vitamin K is also given to treat and prevent vitamin
K deficiency. It is also used to prevent and treat weak bones (osteoporosis) and relieve itching that
often accompanies a liver disease called biliary cirrhosis.
People apply vitamin K to the skin to remove spider veins, bruises, scars, stretch marks and
burns. It is also used topically to treat rosacea, a skin condition that causes redness and pimples
on the face. After surgery, vitamin K is used to speed up skin healing and reduce bruising and
swelling.
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Healthcare providers also give vitamin K by injection to treat clotting problems.
An increased understanding of the role of vitamin K in the body beyond blood clotting led some
researchers to suggest that the recommended amounts for dietary intake of vitamin K be
increased. In 2001, the National Institute of Medicine Food and Nutrition Board increased their
recommended amounts of vitamin K slightly, but refused to make larger increases. They explained
there wasn’t enough scientific evidence to make larger increases in the recommended amount of
vitamin K.
Vitamin K is effective for:
 Treating and preventing vitamin K deficiency.
 Preventing certain bleeding or blood clotting problems.
 Reversing the effects of too much warfarin used to prevent blood clotting.
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Insufficient evidence for:
More evidence is needed to rate vitamin K for these uses.
 Weak bones (osteoporosis) So far, research results on the effects of vitamin K on bone
strength and fracture risk in people with osteoporosis don’t agree.
 Cystic fibrosis
 Heart disease
 High cholesterol
 Spider veins
 Bruises
 Scars
 Stretch marks
 Burns
 Swelling
 Other conditions
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Vitamin K
Safety:
Vitamin K is safe for most people. Most people do not experience any side effects when taking in the
recommended amount each day.
Special Precautions & Warnings:
 Pregnancy and breast-feeding: When taken in the recommended amount each day, vitamin K
is considered safe for pregnant and breast-feeding women, but don't use higher amounts
without the advice of your healthcare professional.
 Kidney disease: Too much vitamin K can be harmful if you are receiving dialysis treatments
due to kidney disease.
 Liver disease: Vitamin K is not effective for treating clotting problems caused by severe liver
disease. In fact, high doses of vitamin K can make clotting problems worse in these people.
Interactions:
Warfarin (Coumadin) interacts with VITAMIN K.
Vitamin K is used by the body to help blood clot. Warfarin is used to slow blood clotting. By helping
the blood clot, vitamin K might decrease the effectiveness of warfarin. Be sure to have your blood
checked regularly. The dose of your warfarin might need to be changed.
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Vitamin K
Dosage:
The following doses have been studied in scientific research:
By mouth:
For bleeding disorders such as hypoprothrombinemia: 2.5-25 mg of vitamin K1 (phytonadione).
For counteracting bleeding that can occur when too much of the anticoagulant warfarin is given:
1-5 mg of vitamin K is typically used; however, the exact dose needed is determined by a lab test
called the INR.
There isn't enough scientific information to determine recommended dietary allowances (RDAs) for
vitamin K, so daily adequate intake (AI) recommendations have been formed instead: The AIs are:
infants 0-6 months, 2 mcg; infants 6-12 months, 2.5 mcg; children 1-3 years, 30 mcg; children 4-8
years, 55 mcg; children 9-13 years, 60 mcg; adolescents 14-18 years (including those who are
pregnant or breast-feeding), 75 mcg; men over 19 years, 120 mcg; women over 19 years (including
those who are pregnant and breast-feeding), 90 mcg.
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Vitamins & Supplements
Magnesium
Magnesium, an abundant mineral in the body, is naturally present in many foods, added to other
food products, available as a dietary supplement and present in some medicines (such as
antacids and laxatives). Magnesium is a cofactor in more than 300 enzyme systems that regulate
diverse biochemical reactions in the body, including protein synthesis, muscle and nerve function,
blood glucose control and blood pressure regulation. Magnesium is required for energy
production, oxidative phosphorylation and glycolysis. It contributes to the structural development
of bone and is required for the synthesis of DNA, RNA and the antioxidant glutathione.
Magnesium also plays a role in the active transport of calcium and potassium ions across cell
membranes, a process that is important to nerve impulse conduction, muscle contraction and
normal heart rhythm.
An adult body contains approximately 25g magnesium, with 50% to 60% present in the bones and
most of the rest in soft tissues. Less than 1% of total magnesium is in blood serum, and these
levels are kept under tight control. Normal serum magnesium concentrations range between 0.75
and 0.95 millimoles (mmol)/L. Hypomagnesemia is defined as a serum magnesium level less than
0.75 mmol/L. Magnesium homeostasis is largely controlled by the kidney, which typically excretes
about 120 mg magnesium into the urine each day. Urinary excretion is reduced when magnesium
status is low.
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Magnesium
Assessing magnesium status is difficult because most magnesium is inside cells or in bone. The
most commonly used and readily available method for assessing magnesium status is
measurement of serum magnesium concentration, even though serum levels have little correlation
with total body magnesium levels or concentrations in specific tissues. Other methods for assessing
magnesium status include measuring magnesium concentrations in erythrocytes, saliva, and urine;
measuring ionized magnesium concentrations in blood, plasma, or serum; and conducting a
magnesium-loading (or "tolerance") test. No single method is considered satisfactory. Some experts
but not others consider the tolerance test (in which urinary magnesium is measured after parenteral
infusion of a dose of magnesium) to be the best method to assess magnesium status in adults. To
comprehensively evaluate magnesium status, both laboratory tests and a clinical assessment might
be required.
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Magnesium
Recommended Dietary Allowances for Magnesium:
Age
Male
Female
Pregnancy
Lactation
Birth to 6 months
30 mg*
30 mg*
7–12 months
75 mg*
75 mg*
1–3 years
80 mg
80 mg
4–8 years
130 mg
130 mg
9–13 years
240 mg
240 mg
14–18 years
410 mg
360 mg
400 mg
360 mg
19–30 years
400 mg
310 mg
350 mg
310 mg
31–50+ years
420 mg
320 mg
360 mg
320 mg
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Magnesium
Sources of magnesium:
Food
Magnesium is widely distributed in plant and animal foods and in beverages. Green leafy
vegetables, such as spinach, legumes, nuts, seeds and whole grains, are good sources. In
general, foods containing dietary fiber provide magnesium. Magnesium is also added to some
breakfast cereals and other fortified foods. Some types of food processing, such as refining grains
in ways that remove the nutrient-rich germ and bran, lower magnesium content substantially.
Tap, mineral, and bottled waters can also be sources of magnesium, but the amount of magnesium
in water varies by source and brand (ranging from 1 mg/L to more than 120 mg/L).
Approximately 30% to 40% of the dietary magnesium consumed is typically absorbed by the body.
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Vitamins & Supplements
Magnesium
Food
Milligrams (mg) per
serving
Almonds, dry roasted, 1 ounce
80
Spinach, boiled, ½ cup
78
Cashews, dry roasted, 1 ounce
74
Peanuts, oil roasted, ¼ cup
63
Cereal, shredded wheat, 2 large biscuits
61
Soymilk, plain or vanilla, 1 cup
61
Black beans, cooked, ½ cup
60
Edamame, shelled, cooked, ½ cup
50
Peanut butter, smooth, 2 tablespoons
49
Bread, whole wheat, 2 slices
46
Avocado, cubed, 1 cup
44
Potato, baked with skin, 3.5 ounces
43
Rice, brown, cooked, ½ cup
42
Yogurt, plain, low fat, 8 ounces
42
Breakfast cereals, fortified with 10% of the Daily 40
Value for magnesium
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Percent
Daily Value
20
20
19
16
15
15
15
13
12
12
15
11
11
11
10
119
Vitamins & Supplements
Magnesium
Food
Oatmeal, instant, 1 packet
Kidney beans, canned, ½ cup
Banana, 1 medium
Salmon, Atlantic, farmed, cooked, 3 ounces
Milk, 1 cup
Halibut, cooked, 3 ounces
Raisins, ½ cup
Chicken breast, roasted, 3 ounces
Beef, ground, 90% lean, pan broiled, 3 ounces
Broccoli, chopped and cooked, ½ cup
Rice, white, cooked, ½ cup
Apple, 1 medium
Carrot, raw, 1 medium
Office of Dietary Supplements –
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Milligrams (mg) per
serving
36
35
32
26
24–27
24
23
22
20
12
10
9
7
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Percent
Daily Value
9
9
8
7
6–7
6
6
6
5
3
3
2
2
120
Vitamins & Supplements
Magnesium
Sources of magnesium:
 Dietary supplements
Magnesium supplements are available in a variety of forms, including magnesium oxide, citrate
and chloride. The Supplement Facts panel on a dietary supplement label declares the amount of
elemental magnesium in the product, not the weight of the entire magnesium-containing
compound. Absorption of magnesium from different kinds of magnesium supplements varies.
Forms of magnesium that dissolve well in liquid are more completely absorbed in the gut than
less soluble forms. Small studies have found that magnesium in the aspartate, citrate, lactate
and chloride forms is absorbed more completely and is more bioavailable than magnesium
oxide and magnesium sulfate. One study found that very high doses of zinc from supplements
(142 mg/day) can interfere with magnesium absorption and disrupt the magnesium balance in
the body.
 Medicines
Magnesium is a primary ingredient in some laxatives. Phillips' Milk of Magnesia®, for example,
provides 500 mg elemental magnesium (as magnesium hydroxide) per tablespoon. Magnesium
is also included in some remedies for heartburn and upset stomach due to acid indigestion.
Extra-strength Rolaids®, for example, provides 55 mg elemental magnesium (as magnesium
hydroxide) per tablet, although Tums® is magnesium free.
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Magnesium
Magnesium intakes and status:
Dietary surveys of people in the United States consistently show that intakes of magnesium are
lower than recommended amounts. An analysis of data from the National Health and Nutrition
Examination Survey (NHANES) of 2005–2006 found that a majority of Americans of all ages ingest
less magnesium from food than their respective EARs; adult men aged 71 years and older and
adolescent females are most likely to have low intakes. In a study using data from NHANES 2003–
2006 to assess mineral intakes among adults, average intakes of magnesium from food alone were
higher among users of dietary supplements (350 mg for men and 267 mg for women, equal to or
slightly exceeding their respective EARs) than among nonusers (268 mg for men and 234 for
women). When supplements were included, average total intakes of magnesium were 449 mg for
men and 387 mg for women, well above EAR levels.
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Magnesium
Magnesium deficiency:
Symptomatic magnesium deficiency due to low dietary intake in otherwise-healthy people is
uncommon because the kidneys limit urinary excretion of this mineral. However, habitually low
intakes or excessive losses of magnesium due to certain health conditions, chronic alcoholism
and/or the use of certain medications can lead to magnesium deficiency.
Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and
weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and
cramps, seizures, personality changes, abnormal heart rhythms and coronary spasms can occur.
Severe magnesium deficiency can result in hypocalcemia or hypokalemia (low serum calcium or
potassium levels, respectively) because mineral homeostasis is disrupted.
Groups at risk of magnesium inadequacy:
Magnesium inadequacy can occur when intakes fall below the RDA but are above the amount
required to prevent overt deficiency. The following groups are more likely than others to be at risk
of magnesium inadequacy because they typically consume insufficient amounts or they have
medical conditions (or take medications) that reduce magnesium absorption from the gut or
increase losses from the body.
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Magnesium




People with gastrointestinal diseases
The chronic diarrhea and fat malabsorption resulting from Crohn's disease, celiac disease and
regional enteritis can lead to magnesium depletion over time. Resection or bypass of the small
intestine, especially the ileum, typically leads to malabsorption and magnesium loss.
People with type 2 diabetes
Magnesium deficits and increased urinary magnesium excretion can occur in people with
insulin resistance and/or type 2 diabetes. The magnesium loss appears to be secondary to
higher concentrations of glucose in the kidney that increase urine output.
People with alcohol dependence
Poor dietary intake and nutritional status; gastrointestinal problems, including vomiting,
diarrhea and fatty stools resulting from pancreatitis; renal dysfunction with excess excretion of
magnesium into the urine; phosphate depletion; vitamin D deficiency; acute alcoholic
ketoacidosis; and hyperaldosteronism secondary to liver disease may contribute to decreased
magnesium status.
Older adults
Magnesium absorption from the gut decreases and renal magnesium excretion increases with
age. Older adults are also more likely to have chronic diseases or take medications that alter
magnesium status, which can increase their risk of magnesium depletion.
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Vitamins & Supplements
Zinc
What is zinc and what does it do?
Zinc is a nutrient that people need to stay healthy. Zinc is found in cells throughout the body. It
helps the immune system fight off invading bacteria and viruses. The body also needs zinc to
make proteins and DNA, the genetic material in all cells. During pregnancy, infancy and childhood,
the body needs zinc to grow and develop properly. Zinc also helps wounds heal and is important
for proper senses of taste and smell.
How much zinc do I need?
The amount of zinc you need each day
depends on your age. Average daily
recommended amounts for different ages are
listed here in milligrams (mg):
Office of Dietary Supplements –
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Life Stage
Recommended Amount
Birth to 6 months
2 mg
Infants 7–12 months
3 mg
Children 1–3 years
3 mg
Children 4–8 years
5 mg
Children 9–13 years
8 mg
Teens 14–18 years (boys)
11 mg
Teens 14–18 years (girls)
9 mg
Adults (men)
11 mg
Adults (women)
8 mg
Pregnant teens
12 mg
Pregnant women
11 mg
Breastfeeding teens
13 mg
Breastfeeding women
12 mg
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Zinc
What foods provide zinc?
Zinc is found in a wide variety of foods. You can get recommended amounts of zinc by eating a
variety of foods including the following:
 Oysters, which are the best source of zinc.
 Red meat, poultry, seafood such as crab and lobsters and fortified breakfast cereals.
 Beans, nuts, whole grains and dairy products.
What kinds of zinc dietary supplements are available?
Zinc is present in almost all multivitamin/mineral dietary supplements. It is also available alone or
combined with calcium, magnesium or other ingredients in dietary supplements. Dietary
supplements can have several different forms of zinc including zinc gluconate, zinc sulfate and zinc
acetate. Zinc is also found in some oral over-the-counter products, including those labeled as
homeopathic medications for colds. Use of nasal sprays and gels that contain zinc has been
associated with the loss of the sense of smell, in some cases long-lasting or permanent. Currently,
these safety concerns have not been found to be associated with oral products containing zinc,
such as cold lozenges. Zinc is also present in some denture adhesive creams. Using large
amounts of these products, beyond recommended levels, could lead to excessive zinc intake and
copper deficiency causing neurological problems (numbness and weakness in the arms and legs).
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Zinc
Am I getting enough zinc?
Most people in the United States get enough zinc from the foods they eat. However, certain groups
of people are more likely than others to have trouble getting enough zinc:
 People who have had gastrointestinal surgery, such as weight loss surgery, or who have
digestive disorders, such as ulcerative colitis or Crohn's disease. These conditions can both
decrease the amount of zinc that the body absorbs and increase the amount lost in the urine.
 Vegetarians because they do not eat meat, which is a good source of zinc. Also, the beans
and grains they typically eat have compounds that keep zinc from being fully absorbed by the
body. For this reason, vegetarians might need to eat as much as 50% more zinc than the
recommended amounts.
 Older infants who are breastfed because breast milk does not have enough zinc for infants
over 6 months of age. Older infants who do not take formula should be given foods that have
zinc such as pureed meats. Formula-fed infants get enough zinc from infant formula.
 Alcoholics because alcoholic beverages decrease the amount of zinc that the body absorbs
and increase the amount lost in the urine. Also, many alcoholics eat a limited amount and
variety of food, so they may not get enough zinc.
 People with sickle cell disease because they might need more zinc.
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Zinc
What happens if I don't get enough zinc?
Zinc deficiency is rare in North America. It causes slow growth in infants and children, delayed
sexual development in adolescents and impotence in men. Zinc deficiency also causes hair loss,
diarrhea, eye and skin sores and loss of appetite. Weight loss, problems with wound healing,
decreased ability to taste food and lower alertness levels can also occur.
Many of these symptoms can be signs of problems other than zinc deficiency. If you have these
symptoms, your doctor can help determine whether you might have a zinc deficiency.
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Zinc
What are some effects of zinc on health?
Scientists are studying zinc to learn about its effects on the immune system (the body's defense
system against bacteria, viruses, and other foreign invaders). Scientists are also researching
possible connections between zinc and the health problems discussed below.
 Immune system and wound healing
The body's immune system needs zinc to do its job. Older people and children in developing
countries who have low levels of zinc might have a higher risk of getting pneumonia and other
infections. Zinc also helps the skin stay healthy. Some people who have skin ulcers might
benefit from zinc dietary supplements, but only if they have low levels of zinc.
 Diarrhea
Children in developing countries often die from diarrhea. Studies show that zinc dietary
supplements help reduce the symptoms and duration of diarrhea in these children, many of
whom are zinc deficient or otherwise malnourished. The World Health Organization and
UNICEF recommend that children with diarrhea take zinc for 10–14 days (20 mg/day, or 10
mg/day for infants under 6 months). It is not clear whether zinc dietary supplements can help
treat diarrhea in children who get enough zinc, such as most children in the United States.
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Vitamins & Supplements
Zinc


The common cold
Some studies suggest that zinc lozenges or syrup (but not zinc dietary supplements in pill
form) help speed recovery from the common cold and reduce its symptoms if taken within 24
hours of coming down with a cold. However, more study is needed to determine the best dose
and form of zinc, as well as how long it should be taken before zinc can be recommended as a
treatment for the common cold.
Age-Related Macular Degeneration (AMD)
AMD is an eye disease that gradually causes vision loss. Research suggests that zinc 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 80 mg zinc, 500 mg vitamin C, 400 IU vitamin
E, 15 mg beta-carotene and 2 mg copper for about 6 years had a lower chance of developing
advanced AMD and less vision loss than those who did not take the dietary supplement.
In the same study, people at high risk of the disease who took dietary supplements containing only
zinc also had a lower risk of getting advanced AMD than those who did not take zinc dietary
supplements. More research is needed before doctors can recommend zinc dietary supplements
for patients with AMD. However, people who have or are developing the disease might want to talk
with their doctor about taking dietary supplements.
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Zinc
Can zinc be harmful?
Yes, if you get too much. Signs of too much zinc include nausea, vomiting, loss of appetite,
stomach cramps, diarrhea and headaches. When people take too much zinc for a long time, they
sometimes have problems such as low copper levels, lower immunity, and low levels of HDL
cholesterol (the "good" cholesterol).
The safe upper limits for zinc are listed here. These levels do not apply to people who are taking
zinc for medical reasons under the care of a doctor:
Life Stage
Upper Safe Limit
Birth to 6 months
4 mg
Infants 7–12 months
5 mg
Children 1–3 years
7 mg
Children 4–8 years
12 mg
Children 9–13 years
23 mg
Teens 14–18 years
34 mg
Adults
40 mg
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Zinc
Are there any interactions with zinc that I should know about?
Yes. Zinc dietary supplements can interact or interfere with medicines that you take and, in some
cases, medicines can lower zinc levels in the body. Here are several examples:
 Taking a zinc dietary supplement along with quinolone or tetracycline antibiotics (such as
Cipro®, Achromycin®, and Sumycin®) reduces the amount of both zinc and the antibiotic that
the body absorbs. Taking the antibiotic at least 2 hours before or 4–6 hours after taking a zinc
dietary supplement helps minimize this effect.
 Zinc dietary supplements can reduce the amount of penicillamine (a drug used to treat
rheumatoid arthritis) that the body absorbs. They also make penicillamine work less well.
Taking zinc dietary supplements at least 2 hours before or after taking penicillamine helps
minimize this effect.
 Thiazide diuretics, such as chlorthalidone (brand name Hygroton®) and hydrochlorothiazide
(brand names Esidrix® and HydroDIURIL®) increase the amount of zinc lost in the urine.
Taking thiazide diuretics for a long time could decrease the amount of zinc in the body.
Tell your doctor, pharmacist or other health care providers about any dietary supplements or
medicines you take, they can tell you if those dietary supplements might interact or interfere with
your medication or how your body absorbs, uses or breaks down nutrients.
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Vitamins & Supplements
Zinc
Food
Oysters, cooked, breaded and fried, 3 ounces
Beef chuck roast, braised, 3 ounces
Crab, Alaska king, cooked, 3 ounces
Beef patty, broiled, 3 ounces
Breakfast cereal, fortified with 25% of the Daily Value for zinc,
¾ cup serving
Lobster, cooked, 3 ounces
Pork chop, loin, cooked, 3 ounces
Baked beans, canned, plain or vegetarian, ½ cup
Chicken, dark meat, cooked, 3 ounces
Yogurt, fruit, low fat, 8 ounces
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Milligrams (mg)
per serving
74.0
7.0
6.5
5.3
3.8
Percent Daily
Value
493
47
43
35
25
3.4
2.9
2.9
2.4
1.7
23
19
19
16
11
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Vitamins & Supplements
Zinc
Food
Cashews, dry roasted, 1 ounce
Chickpeas, cooked, ½ cup
Cheese, Swiss, 1 ounce
Oatmeal, instant, plain, prepared with water, 1 packet
Milk, low-fat or non fat, 1 cup
Almonds, dry roasted, 1 ounce
Kidney beans, cooked, ½ cup
Chicken breast, roasted, skin removed, ½ breast
Cheese, cheddar or mozzarella, 1 ounce
Peas, green, frozen, cooked, ½ cup
Flounder or sole, cooked, 3 ounces
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Milligrams (mg)
per serving
1.6
1.3
1.2
1.1
1.0
0.9
0.9
0.9
0.9
0.5
0.3
Percent Daily
Value
11
9
8
7
7
6
6
6
6
3
2
134
Vitamins & Supplements
Multi-Vitamins
What are multivitamin/mineral (MVM) dietary supplements?
Multivitamin/mineral (MVM) supplements contain a combination of vitamins and minerals and
sometimes other ingredients as well. They go by many names, including multis and multiples or
simply vitamins. The vitamins and minerals in MVMs have unique roles in the body.
What kinds of MVM supplements are available?
There are many types of MVMs in the marketplace. Manufacturers choose which vitamins,
minerals and other ingredients, as well as their amounts, to include in their products.
Among the most common MVMs are basic, once-daily products containing all or most vitamins
and minerals, with the majority in amounts that are close to recommended amounts. Higherpotency MVMs often come in packs of two or more pills to take each day. Manufacturers promote
other MVMs for special purposes, such as better performance or energy, weight control or
improved immunity. These products usually contain herbal and other ingredients (such as
echinacea and glucosamine) in addition to vitamins and minerals.
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Multi-Vitamins
The recommended amounts of nutrients people should get vary by age and gender and are known
as Recommended Dietary Allowances (RDAs) and Adequate Intakes (AIs). One value for each
nutrient, known as the Daily Value (DV), is selected for the labels of dietary supplements and foods.
A DV is often, but not always, similar to one's RDA or AI for that nutrient. The label provides the
%DV so that you can see how much (what percentage) a serving of the product contributes to
reaching the DV.
What are some effects of MVMs on health?
People take MVMs for many reasons. Here are some examples of what research has shown about
using them to increase nutrient intakes, promote health and reduce the risk of disease.
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Vitamins & Supplements
Multi-Vitamins


Increase nutrient intakes
Taking an MVM increases nutrient intakes and helps people get the recommended amounts of
vitamins and minerals when they cannot or do not meet these needs from food alone. But
taking an MVM can also raise the chances of getting too much of some nutrients, like iron,
vitamin A, zinc, niacin, and folic acid, especially when a person uses more than a basic, oncedaily product.
Some people take an MVM as a form of dietary or nutritional "insurance." Ironically, people
who take MVMs tend to consume more vitamins and minerals from food than those who don't.
Also, the people least likely to get enough nutrients from diet alone who might benefit from
MVMs are the least likely to take them.
Health promotion and chronic disease prevention
For people with certain health problems, specific MVMs might be helpful. For example, a
study showed that a particular high-dose formula of several vitamins and minerals slowed
vision loss in some people with age-related macular degeneration. Although a few studies
show that MVMs might reduce the overall risk of cancer in certain men, most research shows
that healthy people who take an MVM do not have a lower chance of getting cancer, heart
disease, or diabetes. Based on current research, it's not possible to recommend for or against
the use of MVMs to stay healthier longer.
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Multi-Vitamins
One reason we know so little about whether MVMs have health benefits is that studies often use
different products, making it hard to compare their results to find patterns. Many MVMs are
available and manufacturers can change their composition at will. It is therefore difficult for
researchers to study whether a specific combination of vitamins and minerals affects health. Also,
people with healthier diets and lifestyles are more likely to take dietary supplements, making it
hard to identify any benefits from the MVMs.
Can MVMs be harmful?
Taking a basic MVM is unlikely to pose any risks to health. But if you consume fortified foods and
drinks or take other dietary supplements, make sure that the MVM you take doesn't cause your
intake of any vitamin or mineral to go above the upper safe levels.
Pay particular attention to the amounts of vitamin A, beta-carotene and iron in the MVM.
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Multi-Vitamins
Should I take an MVM?
MVMs cannot take the place of eating a variety of foods that are important to a healthy diet. Foods
provide more than vitamins and minerals, they also have fiber and other ingredients that may have
positive health effects. People who don't get enough vitamins and minerals from food alone, are on
low-calorie diets, have a poor appetite, or avoid certain foods might consider taking an MVM.
Some people might benefit from taking certain nutrients found in MVMs. For example:
 Women who might become pregnant should get 400 mcg/day of folic acid from fortified foods
and/or dietary supplements to reduce the risk of birth defects in their newborn babies.
 Pregnant women should take an iron supplement as recommended by their health care
provider. A prenatal MVM is likely to provide iron.
 Breastfed and partially breastfed infants should receive vitamin D supplements of 400 IU/day,
as should non-breastfed infants who drink less than about 1 quart per day of vitamin D-fortified
formula or milk.
 In postmenopausal women, calcium and vitamin D supplements may increase bone strength
and reduce the risk of fractures.
 People over 50 should get recommended amounts of vitamin B12 from fortified foods and/or
dietary supplements as they might not absorb enough of the B12 naturally found in food.
Office of Dietary Supplements –
National Institutes of Health
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Multi-Vitamins
Women who get too much vitamin A during pregnancy can increase the risk of birth defects in their
babies. This risk does not apply to beta-carotene, however. Smokers and perhaps former smokers,
should avoid MVMs with large amounts of beta-carotene and vitamin A because these ingredients
might increase the risk of developing lung cancer.
Adult men and postmenopausal women should avoid taking MVMs that contain 18 mg or more of
iron unless their doctor has told them that they have iron deficiency or inadequacy. When the body
takes in much more iron than it can eliminate, the iron can collect in body tissues and organs, such
as the liver and heart and damage them. Iron supplements are a leading cause of poisoning in
children under age 6, so keep any products containing iron (such as children's chewable MVMs or
adults' iron supplements) out of children's reach.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Multi-Vitamins
Are there any interactions with MVMs that I should know about?
MVMs with recommended intake levels of nutrients don't usually interact with medications, with
one important exception. If you take medicine to reduce blood clotting, such as warfarin
(Coumadin® and other brand names), talk to your health care provider before taking any MVM or
dietary supplement with vitamin K. Vitamin K lowers the drug's effectiveness and doctors base the
medicine dose partly on the amount of vitamin K you usually consume in foods and supplements.
Which kind of MVM should I choose?
Talk to a health care provider to help you figure out whether you should take an MVM and, if so,
which one is best for you. Consider basic MVMs whose amounts of most or all vitamins and
minerals do not go above the DVs. These MVMs usually have low amounts of calcium and
magnesium, so some people might need to take one or both minerals separately. Make sure that
the product does not have too much vitamin A and iron.
Also consider choosing an MVM designed for your age, sex, and other factors (like pregnancy).
MVMs for men often contain little or no iron, for example. MVMs for seniors usually provide more
calcium and vitamins D and B12 and less iron than MVMs for younger adults. Prenatal MVMs for
pregnant women often provide vitamin A as beta-carotene.
Office of Dietary Supplements –
National Institutes of Health
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Vitamins & Supplements
Works Cited
MayoClinic, 2013. http://www.mayoclinic.org/
Office of Dietary Supplements, National Institutes of Health. 2013. http://ods.od.nih.gov/
Vitamin D Council. 2013. http://www.vitamindcouncil.org/
WebMD. 2013. http://www.webmd.com/
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The Health Coach Group was founded by Cathy Sykora to help many people
find health and wellness through lifestyle changes. She works toward disease
prevention to replace the need for diagnosis and treatment. The Health Coach
Group makes up a new layer in health care that will bring many who need it to
a better quality of life.
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