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As seen on the Sally Show 4/17/2000



Vitamins & Minerals -
Tom Kruzel N.D.
American Association of Naturopathic Physicians

Choosing a multivitamin or an individual vitamin supplement is often confusing. Deciding if you need or should take vitamins further contributes to the confusion. Add to this the promotional hype about supplements and the issue becomes very cloudy indeed! Ideally, the proper combination of vitamins and minerals should come from food sources. 

Nature has provided an abundance of vitamins and minerals conveniently wrapped up in organic packages designed for maximum absorption and utilization by the body. 

What nature provides, processing takes away, with much of the nutrient value being lost. This is why some vitamin and mineral supplementation is needed.

So what is the best type of vitamin & mineral to take?

Good question; and, depending upon whom you ask, you'll get different answers. Manufacturers have invented new and different ways of compounding vitamins and minerals so they'll be better absorbed. Studies are cited which "demonstrate" the increased bowel uptake of their product. 

Several studies comparing the different varieties of vitamin supplements have shown little if any difference as far as their ability to be utilized by the body. It appears that if a person is in need of a particular substance, then they'll absorb it no matter what form it's taken in. 

This is because the body alters the binding sites on the cell surface to absorb more of the deficient nutrient. 

What this means is that if you need it , it will be absorbed and if not, then it won't be absorbed as much. 

How much should I take ? This is dependent upon a number of factors which your physician can assess. 

We first look for the signs of a vitamin or mineral deficiency through the history and physical examination. 

Next we look at dietary intake to assess the nature, quality and variety of the food. Notice that I didn't say quantity of food. This is because most people take in large quantities of nutritionally deplete food which only provides excessive calories. People often feel hungry shortly after eating because there haven't been enough nutrients, resulting in over weight and under nourished people.


 In general, a small amount of supplementation with meals is recommended every day.
 During the winter months, slightly higher amounts of specific vitamins such as C and B complex may be needed as metabolism changes to meet the demands of the colder weather. Additionally, they provide protection from the increased exposure to colds and flu's.
 During the summer, a smaller amount of supplementation is required as the diet is higher in fruits and vegetables which are abundant in nutrients.
 The elderly should take slightly higher amounts of vitamins and minerals as the ability to absorb nutrients becomes less with age. Certainly the requirements for nutrients does not change but the requirements for calories is lower.
 Taking too many vitamins and minerals however, results in waste and vitamin toxicity.

If you have questions about your vitamin and mineral supplementation, please do not hesitate to contact your physician as they can provide a comprehensive nutritional evaluation.

What is the best brand?

There is no "best" brand to buy, despite what advertisers tell you. We recommend that you read the label as when buying any item, to see if coloring or preservatives have been added. If you have questions about over-the-counter brands, your naturopathic physician can provide a list of multivitamins which are rated as to vitamin content and economic value.

REMEMBER Ė taking too much of some vitaminís can kill you. (liver damage, kidney damage, etc.)

Be smart when you take vitaminís. Check with a medical professional first. Vitaminís can interact with other drugs. Both over-the-counter and prescription. Make sure you consult with your physician.

The Associated Press

WASHINGTON -- The kidney transplant recipient drank grapefruit juice after taking his daily pill and became confused and began trembling. The heart attack survivor thought taking high-dose vitamin E with his medicine would better protect his heart, until he began bleeding.

Everyday foods and vitamins can sometimes dangerously interact with the prescription drugs used by 85 million Americans and over-the-counter medicines taken by countless others, warns a new consumer campaign that lists what foods and drugs do not mix.

"You open up any bathroom cabinet in America and you'll see the same thing: medicine, and lots of it," said Linda Golodner, president of the National Consumers League. But eat the wrong food with certain medicines, she said, and "you may end up in the emergency room."
Doctors are supposed to warn patients what drugs not to mix. But potential problems from mixing medicine with other substances, including foods, alcohol, and herbal supplements, aren't as well publicized. So the consumers league, with help from the Food and Drug Administration, published a brochure Wednesday listing drug-food combinations patients should avoid.
Some examples:

Never drink grapefruit juice less than two hours before or five hours after taking any of the heart drugs in the class called calcium channel blockers, such as Procardia. The mix sometimes kills.

High doses of vitamin E inhibit blood clotting. Taken by heart patients on the popular anticoagulant Coumadin, the mix increases the risk of serious bleeding. 

Coumadin users also shouldn't splurge on foods high in vitamin K, such as broccoli, spinach, and turnip greens, which reduce the drugs effectiveness. 

Antidepressants called MAO inhibitors can cause a potentially fatal blood pressure rise when taken with foods high in the chemical tyramine, such as aged cheeses and sausage. Other items to be avoided are smoked, pickled or fermented foods.

Drinking coffee or colas with certain antibiotics such as Cipro or the ulcer drugs Tagamet, Zantac, and Pepcid can increase caffeine levels, causing jitters and stomach irritation.

Too much caffeine increases the dose of theophylline, a bronchodilator, causing nausea, palpitations, and possibly seizures.

Don't overload on bananas or take potassium supplements with heart drugs called ACE inhibitors, such as Capoten and Vasotec. It can cause harmful potassium buildup.

Grapefruit juice should never be taken with antihistamines, either prescription versions such as Claritin and Allegra or over-the-counter types such as Benadryl. It can cause serious heart problems.

Grapefruit juice taken with cyclosporin, which fights organ rejection in transplant recipients, can cause confusion and trembling. although grapefruit juice has the bad reputation, eating grapefruit may cause the same interactions, said Michael Bottorff, a University of Cincinnati pharmacist.

No one knows how often mixing drugs with the wrong foods causes problems, said Dr. Janet Woodcock, director of the FDAs drug division.

Few doctors report the interactions, few consumers know diet could have caused a side effect -- and some interactions, like grapefruits effect on a growing list of medications, have only recently been discovered.

"Both health careprofessional education as well as consumer education is needed," Bottorff added.

He urged patients to report possible drug side effects to a health worker immediately, but said people also should use common sense. Grapefruits effect, for example, "depends on how much grapefruit they take and how often. Half a grapefruit for breakfast once a week might not be enough to cause a problem." For a free copy of "Food & Drug Interactions," call (800) 639-8140 or see the Internet at www.nclnet.org

Avoiding the Lure Of Megavitamins
When it comes to vitamins, the old advice is still the best:

There is no reason to take more than the recommended dietary allowance (RDA) of any vitamin, except for relatively rare indi-viduals who cannot absorb or utilize vitamins adequately. 

If you want nutrition "insurance," take a regular multivitamin capsule containing only the RDA of vitamins.

A megadose is 15 or more times the RDA. This is the level at which toxic effects begin to show up in adults. 

Some of the medical problems adults may experience as a result of prolonged, excessive intake are:

Vitamin A -Dry, cracked skin. Severe head- aches. Severe loss of appetite. Irritability. Bone and joint pains. Menstrual difficulties. Enlarged liver and spleen.

Vitamin A and beta-carotene were recently shown to promote heart disease and cancer in the CARET study. 

The CARET trial showed that beta-carotene plus Vitamin A sup-plements resulted in 28% more deaths from lung - cancer and 17% more deaths from heart disease in American smokers than did a dummy pill. 

The Physicians Health Study of 22,017 doctors randomly assigned to take 50 mg. of beta carotene or a dummy pill every other day ended on 12/31/95 after 12 years. 

It showed that beta -carotene supplements provided no protection whatsoever against cancer or heart disease.

Vitamin D -Loss of appetite. Excessive uri-nation. Nausea and weakness. Weight loss. Hy-pertension. Anemia. Irreversible kidney failure that can lead to death. 

Vitamin E. -Research on Es toxic effects is sketchy, but the findings suggest some prob-lems: Headaches, nausea, fatigue and giddiness, blurred vision, chapped lips and mouth inflam-mation, low blood sugar, increased tendency to bleed, and reduced sexual function. 

Ironically, one of the claims of Vitamin E proponents is that it heightens sexual potency. 

The fact that vitamin E supplements are anticoagulants (like aspirin) may explain why they protect against heart attacks but promote lethal hemorrhagic strokes.

Large doses of Vitamin E enhance im-mune activity and thus may promote progession of immune and auto-immune disease (asthma, food allergies, diabetes, rheumatoid arthritis, multiple sclerosis and lupus).

The B vitamins- Each B has its own charac-teristics and problems. Too much B-6 can lead to liver damage. Too much 13- 1 can destroy B-12.

  Vitamin C- Kidney problems and diarrhea. Adverse effects on growing bones. Rebound scurvy (a condition that can occur when a per-son taking large doses suddenly stops). 

Symp-toms are swollen, bleeding gums, loosening of teeth, roughening of skin, muscle pain.

Vitamin C is the vitamin most often used to excess. 

Some of the symptoms of toxic effect from Vitamin C megadoses:
Menstrual bleeding in pregnant women and various problems for their newborn infants.

Destruction of Vitamin B-12, to the point that B-12 deficiency may become a problem.

False negative test for blood in stool, which can prevent diagnosis of colon cancer.

False urine test for sugar, which can spell trouble for diabetics. An increase in the uric acid level and the precipitation of gout in individuals predisposed to the ailment.

In approximately 10% of non-blacks and 30% of blacks born with a genetic defect which gives them high body iron, Vitamin C supplements are violently pro-oxidant. They generate billions of free radicals, promoting more rapid development of heart disease, cancer and death.

Stephen Barrett, MD, and Victor Herbert, MD, JD, authors of The Vitamin Pushers; How the "Health" Food Industry Is Selling America a Bill of Goods Prometheus Press. Victor Herbert, MD, JD, and Genell Subak--Sharpe, editors, Total Nutriton: The Only Guide You'll Ever Need: From the Facility of the Mt. Sinai School of Medicine. St. Martins Press.

St. Johns Wort (also known by its botanical name, Hypericum perforatum) is derived from a yellow flowering plant. It has been used as an herbal remedy for mild to moderate depression (not recommended for the treatment of severe or manic depression), anxiety, and sleep disturbances/disorders for many years, especially in Germany. Research suggests that St. Johns Wort raises levels of serotonin, norepinephrine, and dopamine -- neurotransmitters which help boost mental morale and mood. 

Unlike prescription anti-depressants (i.e., Prozac, Paxil, Zoloft, Effexor, etc.), which can cause negative side effects ranging from nausea to impaired sex drive and ejaculation, St. Johns Wort has no documented cases of sexual dysfunction. It also appears to increase sleep activity by acting as a mild sedative, and may reduce chronic tension headaches.

Several adverse effects have been reported in association with usage of St. Johns Wort, including:

gastrointestinal discomfort, such as upset
allergic reactions
increased sensitivity to sunlight (so, use a sunscreen or sunblock while on St. Johns Wort)
dry mouth

Components of St. Johns Wort may also cause an increase in blood pressure, which could result in a stroke.

Since St. Johns Wort is a nutritional supplement, which is not regulated by the U.S. Food and Drug Administration (FDA), there is no guarantee of the quality of the supplement from product to product. Carefully read product labels -- look for an extract standardized to 0.3 percent hypericin, the purported active ingredient in St. Johns Wort, and make sure this extract is derived from the whole St. Johns Wort plant (i.e., flowers, leaves, and stem). 

The dosage of St. Johns Wort that has been used in most studies is a 900 milligram daily dose taken in 300 mg increments three times a day. Results may not be seen for at least four to six weeks, if at all. Discontinue use after six weeks if you've noticed no results because it's probably not effective for you.


Herbal Stimulants May Harm Teens
Metabolism boosters put teens in the ER
Metabolism-boosting herbal supplements are marketed as all natural. That means they're safe, right?

A survey of hospital emergency rooms might give you a different impression. Teenagers have been showing up at hospitals complaining of irregular or racing heartbeats. Most have been girls aged 13 to 17 who used supplements such as Metabolife or Metabolift to lose weight or to boost athletic performance.

Although sold as herbal supplements, these products have drug-like ingredients such as guarana, a stimulant similar to caffeine, and ephedra, also know as Ma huang -- a chemical cousin of "speed" or methamphetamine. Excessive use of these products can make the heart race. Although all of the teens treated so far have recovered, the supplements could be dangerous to people with some undiagnosed health problems.

A story from the Pittsburgh Post-Gazette notes that emergency rooms and poison control centers are on alert for additional cases and warn parents about the hazards of herbal stimulants, which are not recommended for anyone under the age of 18.

A feature from Consumer Reports reviews which herbal products have the potential to cause harm, and also lists 10 herbs that medical evidence suggests can promote health Ė when
used properly, of course.

Poison Center warns against childrens use of herbal stimulants
Tuesday, November 16, 1999
By Virginia Linn, Health Editor, Post-Gazette

Since the beginning of September, the Pittsburgh Poison Center at Childrens Hospital has noticed an alarming trend -- an increase in the number of adolescents using large amounts of nutritional supplements containing herbal stimulants.

Hospital emergency rooms and personal physicians have reported to the poison center 25 cases of youngsters taking Metabolife or Metabolift tablets, which contain ephedra guarana.

Ephedra, a stimulant that may be listed on the label as the Chinese herb Ma huang, and guarana, a natural form of caffeine, are mixed to give a person an extra boost of energy and to speed up the bodys metabolism, said Edward P. Krenzelok, director of the poison center. As far as doctors could tell, the youngsters exceeded the recommended dosages of these products, although they didn't know by how much.

The children who took the pills experienced irregular or racing heart beats and an increase of blood pressure. At least one child passed out. All have recovered without problems.

Most of the cases have involved adolescent females, ages 13 to 17, who took the products to enhance athletic performance, or possibly for weight reduction, Krenzelok said.

"Hopefully its not a trend thats going to go hog wild," he said. "I think kids will have to take multiple tablets to run into problems."

The poison center last week issued a warning to parents concerning potential dangers of these products, which are available in nutrition stores and mall kiosks. 

Although these herbal products are not regulated by the Food and Drug Administration, warnings on the bottles state they shouldn't be used by people under age 18.

"I don't see any merit to the product at all," Krenzelok said.
Effects can be devastating for people who have pre-existing conditions such as a brain aneurysms or to those who have extra sensitivity to stimulants. Ephedrine, a stimulant banned in some sports, can cause anxiety, insomnia, hypertension, kidney damage, heart attack, stroke and even death.

The poison center noticed the increase when reviewing its reports for the year. Between January and September, the center received nine calls involving these supplements, but the number took off at the beginning of the school year.

Most of the reports have come from hospitals or doctors in the North Hills and eastern suburbs, he said.

Among the 25 reports were four cases of children under age 3 who accidentally ingested tablets that were sitting around the home. These children experienced no complications because they didn't take enough to cause problems.

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