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Ideally, patients should be able to get all the nutrients their body requires by eating a balanced diet of unprocessed foods. Supplementing a diet lacking in nutrition is sometimes necessary but supplementation should not be used simply to forgo nutritious foods.
 

Experts: Don't Waste Your Money on Multivitamins
Three studies find the supplements don't help extend life or ward off heart disease and memory loss

The US Preventive Services Task Force (USPSTF) has concluded that there is insufficient evidence to determine whether vitamins help prevent cancer or cardiovascular disease,

Natural sources of nutrients are always preferable because they may contain important nutrients not available anywhere else or not even identified yet.
Although supplemental vitamins are very popular, there is no solid evidence that they contribute to long-term health, reduce symptoms or cure chronic disease. See Skip the Supplements.
 
Extra vitamins or minerals are not recommended unless the diet is compromised by intolerances to foods, or absorption is limited due to gastric inflammation.
 
Patients who are concerned that their diet is less than ideal should study the Recommended Daily Allowance (RDA) values of the standard nutrients and examine their diet to determine if they are deficient. Our recommendation is to take only enough supplementation to reach the RDA. Don't forget to check processed foods for the list of supplemented vitamins and minerals when determining dietary deficiency.
 
See this link for RDA and food sources of vitamins.
 
Multivitamins and B-complex vitamins can be purchased without Vitamin D but they contain folic acid. In order to avoid added vitamin D and folic acid and/or potential immune-modulating herbs, take each of the necessary supplemental vitamins and minerals separately.
 
B Vitamins
 
Folic Acid
 
The terms ‘folate’ and ‘folic acid’ represent two different forms of the same B vitamin (B-9). Folic acid is the synthetic (man-made) form that is used in vitamin supplements and fortified foods. Folate is the form found naturally in foods. Many times the general term "folate" is used to describe both forms of the vitamin.

We recommend avoiding folic acid in supplements and supplemented foods because it promotes cell growth, including bacterial.

The B-vitamin folate is important for preventing neural tube defects in infants and has been fortified in grains since 1990. Over this time frame such birth defects have reduced by 19%. Yet for non-pregnant women and men, this may not be a good thing. The form of folic acid added to grains is folic acid, the synthetic form of folate. Since the 1950's it was known in the test tube, folic acid fueled the growth of many cancers cells especially colon cancer cells. In fact, most chemotherapy drugs work by blocking folic acid. Since fortification with folic acid began, it appears colon cancer has risen by 15000 cases per year even after factoring in improvements in screening. Other studies have suggested links between folic acid and lung and prostate cancers. See Folic Acid Fortification Might Boost Cancer Risk.

See also Folic acid – a micronutritive and promoter of growth for bacteria and fungus. While L-form bacteria (the type that invade cells and disable the VDR) aren't listed, we can assume they are likely to use folic acid to multiply. Chronic co-infections are also an issue for some and those pathogens would use folic acid to their benefit, making it more difficult for the immune system to kill them. It's interesting to see that high concentrations of folic acid aren't needed for this effect and that folic acid inhibits tetracyclines (e.g., Minocycline).

It’s fine to eat foods naturally high in folate.

Folate is necessary for normal cell growth but it's easy for most people to obtain enough by eating a healthy diet. Excellent natural sources of folate include leafy green vegetables, romaine lettuce, turnip greens, mustard greens, parsley, collard greens, broccoli, asparagus, cauliflower, beets, and lentils, beans and peas, and fruits (like citrus fruits and juices).

Those who suspect they may be deficient should have their serum folate measured before they take a folic acid supplement. If necessary, they should take only the RDA (recommended daily allowance) until their serum folate level is within normal limits. Some may need genetic testing (the MTHFR gene) to see if they use the folate in foods properly.

We are seeing a trend to test homocysteine because high levels have been associated with a number of disease states. Elevated homocysteine is often treated with folic acid supplementation but the need to do this should be verified with a serum folate level.

For patients whose nutrition is substandard and who must supplement B-complex vitamins or eat certain processed foods that contain folic acid, the lesser evil may be to take the folic acid that they contain.
 
Avoid the following sources of folic acid:
  • Multivitamins
  • Folic acid supplements
  • B vitamin multivitamins
  • Fortified white flour (use whole grain)
  • Enriched flour
  • Products made with fortified white flour (including breads, baked goods, cereals)
  • Processed foods supplemented with folic acid

Antioxidants

A new hypothesis that focuses on reactive oxygen species (ROS) proposes that antioxidant levels within cancer cells are a problem and are responsible for resistance to treatment.

The theory destroys any reason for taking antioxidative nutritional supplements, because they "more likely cause than prevent cancer," according to Nobel laureate James Watson, PhD, from Cold Spring Harbor Laboratory, New York.

One far-reaching implication of this theory is that antioxidants as nutritional supplements, including beta-carotene, vitamins A, C, and E, and selenium, could be harmful in cancer. See Novel Cancer Hypothesis Suggests Antioxidants Are Harmful

Beta Carotene
 
Beta Carotene is the pro-Vitamin form of Vitamin A. It is not advisable to take Vitamin A.
 
Vitamin B12 (cobalamine)
 
B12 is readily available in meat and dairy products. Supplemental Vitamin B12 may be needed for patients with a documented deficiency of B12 or who are diagnosed with pernicious anemia, or who eat a vegan diet. Some have found that sublingual Vitamin B-12 (use the hydroxo or methyl form; not the cyano) can help with energy. The recommended dose is 1000-2000 mcg a day.
 
See this linkfor risk factors and tests to determine pernicious anemia or B12 deficiency.

A low B-12 level indicates the need for follow up testing of homocysteine and methylmalonic acid (sMMA) levels. Methylmalonic acid is elevated in true B12 deficiency.

There are other possible causes of cobalamine (Vitamin B12) deficiency, but the term ‘pernicious anemia’ is properly applied only to conditions with a gastric mucosal defect that results in insufficient intrinsic factor. Pernicious anemia is definitely diagnosed with gastric biopsy.
 
Vitamin C
 
Ascorbates promote the transcription of Th1/Th17 inflammatory mediators and, therefore, Vitamin C (ascorbic acid) may prove to affect the immune system in a way that is counterproductive. Because Vitamin C affects the immune system in ways yet to be discovered, it's suggested to avoid supplementation. As little as 10mg per day is needed to prevent Vitamin C deficiency (scurvy). See this link for a list of foods high in Vitamin C.

Studies show that taking Vitamin C daily won't prevent a cold, and if you consume it after feeling sick, it won't ease symptoms.
 
Vitamin E
 
See this link for information about Vitamin E.
 
Vitamin K
 
Vitamin K is being promoted for osteoporosis prevention but deficiency in adults is rare. Intestinal bacteria produce some of the needed vitamin K.
 
Minerals
 
Minerals are inorganic elements which are utilized as structural components of tissue and cellular compounds, as catalysts for enzyme activity, and to maintain normal osmotic and electrochemical gradients that support neuromuscular activity and cell membrane transport activity.
 
See this link for RDA and food sources of common minerals.

 
Magnesium
Low serum magnesium or certain symptoms (e.g., muscle cramps) may indicate the need for magnesium supplementation. There's a sophisticated test that measures intracellular magnesium, which may be more accurate, but it isn't widely available. Serum values are valid but it appears that some can have a "normal" serum value and still need more magnesium for optimal cellular function. In that case, a trial of magnesium supplementation can be used to evaluate its effect on symptoms.
 
The chelated form of magnesium, such as magnesium citrate, glycinate or malate, is absorbed best by your body and less apt to cause diarrhea.
 
Don't take Minocycline within two hours of taking a magnesium supplement because magnesium binds Minocycline in the gut and decreases the absorption of Minocycline.

Topical magnesium is available online and at health food stores. Magnesium chloride, which is sprayed on the skin, doesn't require chelation for optimal absorption.

Supplementation can be achieved and muscles cramps may also be relieved by soaking in an Epsom salt (magnesium sulfate) bath (2 cups) or foot soak (1/2 cup). The body will absorb what it needs without any concern for bowel side effects. Epsom salt may be found at your local grocery store, health food store or pharmacy.

The FDA cautions that ong-term use of prescription proton-pump inhibitors (PPIs) can be associated with hypomagnesemia, which can in turn cause serious muscle spasms (tetany), arrhythmias, and seizures, but may instead be asymptomatic. 

Zinc
 
Vegetarians may need supplemental zinc. Testing can determine if zinc levels are low. The RDA for zinc is determined by gender and age.
 
Three of four well-designed studies found zinc ineffective at preventing or easing symptoms of a cold. A fourth found that zinc nasal gel helped relieve symptoms. But in June09 the FDA recalled some zinc nasal products, since they're linked to a loss of sense of smell.
 
Iron
 
Low levels of hemoglobin and hematocrit do not always indicate iron deficiency. There is detailed information about anemia of chronic disease in our Library of Information. Patients who are found to be iron deficient by appropriate tests should take only enough iron supplement to raise the ferritin level to normal to avoid excess iron which would fuel bacterial cell growth.
 
Boron
 
There is no RDA established for boron which is thought to be important in calcium metabolism. It’s found in leafy vegetables, nuts, grains, apples, raisins, and grapes.
 
Iodine
 
Natural sources of iodine include sea life, such as kelp and certain seafood (all of which should be avoided as they may contain vitamin D), as well as dairy products, and plants grown on iodine-rich soil. Iodized salt is fortified with iodine. In areas where there is little iodine in the diet, iodine deficiency causes hypothyroidism. The addition of iodine to table salt has largely eliminated this problem in wealthy nations.
 
Calcium
 
 
Potassium
 
Do not take potassium supplements without a doctor's approval and periodic testing.
 
Patients with kidney inflammation (it may be sub-clinical), may retain too much potassium due to renal resorption which could be dangerous. Patients with a history of abnormal serum potassium levels should be closely monitored with blood levels. There is detailed information about kidney function and potassiusm in our Libary of Information.