On a recent trip to the grocery store, my shopping list included buying some vitamins. When I reached that aisle, I found lots of options, lots of different packaging. Which ones should I pick? I have to admit it was very confusing.
Therefore, I was really thankful to have the opportunity to interview Sherry Torkos, who is a pharmacist, author, and certified fitness instructor. Sherry has authored 18 books, including Saving Women’s Hearts, The Canadian Encyclopedia for Natural Medicine, The Glycemic Index Made Simple, Winning at Weight Loss and Breaking the Age Barrier. I thought you, too, would be interested in the interview. Here is our question-and-answer session:
Realistically, who needs to take vitamins?
This is a broad question and recommendations vary based upon the individual. A multivitamin can be beneficial for most people to ensure optimal intake of all essential nutrients. Multivitamins can fill in dietary gaps, compensate for depletion caused by stress, intense exercise, use of medications, and other factors that nutrients.
Some of the reasons for using vitamins/supplements include: to complement the diet; to offset nutrient deficiencies caused by poor diet; to maintain health; and to prevent, manage or treat various conditions such as high blood pressure, cholesterol, arthritis, and other chronic problems. Some vitamins can also be helpful for boosting immune function and reducing risk of cold/flu such as vitamin C and D. Calcium, vitamin D and magnesium are important to maintain healthy bones.
We head to the vitamin aisle and there are so, so many choices. How do we make a good selection with all those options that are available?
Ask for help…talk to your pharmacist, naturopath or a health care professional who is knowledgeable about supplements.
Won't a multi-vitamin do the trick? Do we need other vitamins?
A multi is a good “foundation” supplement. However there is only so much that can fit into a tablet/capsule. Most multis provide a broad range of nutrients at certain percentage of the RDA. It is difficult to get ideal amounts of certain nutrients. For example to get the recommended amount of bulky ingredients such as minerals (calcium and magnesium) beyond a multi, it is important for a person to look at their individual health needs, here are some supplements I often recommend:
- Omega-3s - Essential for the health of our brain, nervous system, heart and skin. It is difficult to get enough through diet. Most health authorities recommend 2 servings of fish per week to ensure adequate omega-3 intake, however many people are concerned with the contamination of our fish supply (mercury, dioxins, PCBs - which are even present in wild fish, but to a lesser extent then farmed fish). When looking for a brand, only choose ones that have been clinically researched, like Ocean Blue.
- Probiotics/Prebiotics - Offer a wealth of health benefits - important for gut and immune function and new research has linked certain probiotics to reducing cholesterol, fighting gum disease, and much more.
- Tocotrienols – a super-potent form of vitamin E that offers a range of health benefits. There is a lot of new research showing the tocotrienols can offer powerful health benefits for brain and heart health and even management of fatty liver disease. Look for a tocotrienols supplement derived from Malaysian palm fruit oil, which provides the richest plant source of this antioxidant, or derive the benefits by consuming palm fruit oil. Unlike many plant oils, palm fruit oil is heat stable and thus suited well for cooking.
- Vitamin D – Is essential for strong bones and a proper functioning immune system. There are a host of other emerging benefits including protecting against depression, various cancers, early death, autoimmune disorders and multiple sclerosis. Taking a Vitamin D supplement in the winter is a must to keep your body’s Vitamin D levels optimized.
Will eating a healthy diet mean that we don't need to take vitamins?
Not necessarily. Eating a healthy diet is very important for good health and it would be ideal if we could get all the vitamins, mineral and nutrients from food alone but that is not the case for most people. Most produce today is sprayed with pesticides and grown in nutrient depleted soil and this can impact the nutrient levels. Plus if a person is taking prescription drugs, stressed or exposed to smoke or environmental pollution these factors can result in nutrient depletion.
Are there specific companies that do better -- or worse -- in creating vitamins?
Yes, for sure. It is important to look for a reputable manufacture, such as Ocean Blue, Natural Factors, Jarrow, Douglas Laboratories, Life Extension Foundation to name a few.
Are there potential interactions that we need to consider prior to taking a vitamin?
Yes, supplements can interact with drugs and even each other. Here are some examples:
- Fiber supplements and minerals - reduced absorptions and efficacy
- 5-HTP (supplement used for depression, sleep) acts to raise serotonin and if taken along with St Johns wort and/or SAMe or other products that raise serotonin levels it can be problematic (high serotonin levels can cause a range of serious side effects)
- Calcium can reduce absorption of iron (need to separate these by 2-3 hrs)
- Examples of drug-supplement interactions:
- Licorice and digoxin (risk of digoxin toxicity)
- Red yeast rice extract can potentiate the effects of statin drugs (and the risk of side effects)
- Minerals such as iron and calcium (commonly found in multivitamin formulas) can bind to and reduce activity of quinolone antibiotics. Examples of quinolones include norfloxacin, ciprofloxacin, ofloxacin, and levofloxacin
- Vitamin D - depleted by anti-convulsants (phenytoin and phenobarbital), corticosteroids (prednisone), H2 receptor blockers (acid-blocking drugs such as ranitidine, famoditine) and calcium channel blockers (verapamil)
- Vitamin C - depleted by regular aspirin use, NSAIDS (ibuprofen) and oral contraceptives
There are also examples of positive interactions, where supplements can offset drug side effects, for example:
- Probiotics can offset the side effects of antibiotics (upset stomach, gas, bloating, diarrhea, yeast/thrush)
- Coenzyme Q10 (a vital antioxidant) is depleted by the use of statin drugs (atorvastatin, simvistatin, lovastatin) and this can contribute to the muscle weakness, fatigue and cardiomyopathy. Supplementing with Q10 can offset these side effects and improve tolerability of statin drugs.
There are also many supplements that are contraindicated with various health conditions. This would be an entire article in itself! For example, people with blood clotting disorders need to avoid or be cautious about taking high dose vitamin E and ginkgo biloba and other products that have blood-thinning properties. People that have serious medical conditions such as diabetes, heart disease, cancer, etc. need to be careful and ask for advice from a knowledgeable health care professional when taking supplements.
Increasingly, we're seeing gummy vitamins for adults. Are these OK to take or are there issues with them?
Answer: Gummies are fine; however, most do contain sugar or an alternative sweetener. Gummies and chewables are ideal for those who have a hard time swallowing large tablets or capsules and also for kids.
Published On: November 21, 2013