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Margarita posted a topic in Nutritional & Herbal SupplementsVitamins, dietary minerals and trace elements are essential to the healthy function of the human body. Vitamins are organic compounds that are vital to, but not always produced by, the body and so have to be obtained through the diet. Similarly, dietary minerals (e.g. calcium and phosphorous) and trace elements, of which even smaller amounts are required (e.g. zinc and selenium), are acquired through food. For the majority of people, a balanced, nutritious diet satisfies the body’s vitamin and mineral requirements. There are two types of vitamins; fat soluble and water soluble. Fat soluble vitamins are found mainly in fatty foods and animal products, such as oils, butter, eggs, liver and oily fish. Whilst the body requires a constant supply of these vitamins, the tiny quantities needed coupled with their storage in the liver and fatty tissue for use when required mean that it is not vital to consume them every day. In fact large doses of fat soluble vitamins can be harmful. For example, the risk of lung and stomach cancers is increased in those who consume 20-30mg/day of B-carotene. However many of the side effects seen with excess vitamin intake are not likely to happen as a result of dietary intake, but rather by exceeding the recommended dose with supplementation., ,  Water soluble vitamins such as vitamin C, folic acid and niacin are found in a wide range of foods including vegetables, fruit, potatoes, grains and dairy food. These water soluble vitamins are less stable than fat soluble vitamins. They are often destroyed by heat or air, meaning that they cannot be stored by the body and excesses are excreted in urine. The consumption of foods containing water soluble vitamins is therefore needed more often, to maintain the body’s supply. As they are excreted in the urine, water soluble vitamins are generally less harmful than fat soluble vitamins, although very high doses may have an adverse effect on the body. For example, large doses vitamin C can cause diarrhoea, while excess folic acid can have effects that range from abdominal cramps and nausea to confusion and increased seizure frequency. Dietary minerals and trace elements have many functions including building strong bones and teeth, regulating the composition of the fluid inside and surrounding cells, and converting food to energy. However high doses taken over a long period can be harmful, as demonstrated by the doubling of hospital admissions for gastrointestinal problems, 17% increase in kidney stones and 20-40% increase in the risk of a heart attack in those taking calcium supplements. Despite the fact that a varied, healthy diet will provide adequate amounts of all essential vitamins, minerals and trace elements for most people, the use of dietary supplementation is increasing. There is no real evidence, that taking synthesised vitamins and mineral supplements has any real benefit to health. Furthermore, in addition to a lack of proven efficacy, the manufacture of dietary supplements is not regulated as stringently as that of medicines. This is because they are not classified as a food or a drug, and as such, they are not technically permitted to make any health claims. More worryingly, no clinical trials are required prior to their production and sale. Many supplements are manufactured by synthetic methods and contain additives such as sweeteners, which may be harmful to health, and they can interact with prescribed medications with serious and even life-threatening results. In conclusion, naturally occurring vitamins and microelements are an important part of our diet. Whilst many synthetic supplements are available that contain high doses of these essential nutrients, it is often the case that our dietary intake is sufficient, except in cases of diseases or conditions that result in a vitamin deficiency. The potential for damaging effects seen with high intake of certain man made vitamins, coupled with the possibility for drug interactions means that you could be doing more harm than good by taking these ‘healthy’ supplements.  FAO/WHO (2001) Human vitamin and mineral requirements. Retrieved April 2016 from, http://www.fao.org/3/a-y2809e.pdf  Druesne-Pecollo N, et al. (2010) Beta-carotene supplementation and cancer risk: a systematic review and metaanalysis of randomized controlled trials.Int J Cancer. 127(1). 172-84.  Schwalfenberg, GK. & Genius, SJ. (2015) Vitamin D, Essential Minerals, and Toxic Elements: Exploring Interactions between Nutrients and Toxicants in Clinical Medicine.ScientificWorldJournal. 318595.  Brown, AC. (2016) An overview of Herb and dietary supplement efficacy, safety and government regulations in the United States with suggested improvements. Part 1 of 5 series. Food Chem Toxicol. [epub ahead of print] doi: 10.1016/j.fct.2016.11.001.  Brown, AC. (2016) Liver toxicity related to herbs and dietary supplements: Online table of case reports. Part 3 of 6. Food Chem Toxicol. [epub ahead of print] doi: 10.1016/j.fct.2016.07.001.  CSU (2012) Water-soluble vitamins: B-complex and vitamin C. Retrieved November 2016 from, http://extension.colostate.edu/docs/pubs/foodnut/09312.pdf  CSU (2012) Fat-soluble vitamins: A, D, E, and KB-complex and vitamin C. Retrieved November 2016 from, http://extension.colostate.edu/docs/pubs/foodnut/09315.pdf  Mulholland, CA, Benford, DJ. (2007) What is known about the safety of multivitamin-multimineral supplements for the generally healthy population? Theoretical basis for harm. Am J Clin Nutr. 85(1). 318S-322S  Rogovik, AL, Vohra, S, Goldman, RD. (2010) Safety considerations and potential interactions of vitamins: should vitamins be considered drugs? Ann Pharmacother. 44(2). 311-24.  Shenkin, A. (2006) Micronutrients in health and disease. Postgrad Med J. 82(971). 559-567.  Reid, IR, Bristow, SM, Bolland, MJ. (2015) Calcium supplements: benefits and risks. J Intern Med. 278(4). 354-68.  Williamson, EM. (2003) Drug-interactions between herbal and prescription medicines. Drug Saf. 26(15). 1075-92.
ssangster posted a topic in Vote ArticlesAlthough dietary supplements are not medicines, they still can have side effects based on volume consumed, thus you get warning about how much you can take of them daily, but I found the labels differing on given RDI. I wonder if there is any requirement of safety testing the dietary supplements before they end up on a supermarket shelf, please research and enlighten us.
Drug interactions occur when the effect of a drug is altered if taken in conjunction with another drug, supplement, food, or alcohol. Drugs can interact with dietary supplements either directly or indirectly, increasing or decreasing the drug’s desired effects. Indirect effects can result from changes in excretion, metabolism or, occasionally, absorption of the substance, which can result in reduced or increased pharmacological activity of the drug. This can trigger unexpected and potentially harmful side effects. These interactions can occur in numerous ways, from the way different substances react with each other in the stomach, to the mechanism of metabolism in the body. Such interactions can vary between subjects, as everyone’s body is different in terms of its ability to absorb, metabolise, distribute and excrete drugs and their metabolites. There are several factors that can lead to these differences, including genetic variation, body weight (hence why some drugs are dosed according to this), age, gender (often due to hormone levels), drug tolerance and even diet. An example of the latter is the reduced response to bronchodilators associated with a high-fat diet. Because of these variations, drug interactions can be difficult to predict, even when their reactions are well-known. Western populations consume an ever-increasing amount of dietary supplements, including vitamins, minerals, herbs and many other products. These can come in many forms, such as pills, capsules, powders, drinks and energy bars. Adverse reactions between supplements and prescribed medications are well documented: warfarin, insulin and aspirin, for instance, have a high record of adverse interactions with dietary or herbal supplements. Mixing warfarin and fish oil, for example, can lead to uncontrolled bleeding, while insulin combined with chromium can induce hypoglycaemia in diabetics. The increasing number of dietary supplements available, coupled with the fact that they are not as well-regulated as medicinal products, means the potential for adverse interactions is escalating. Consumers tend to assume that because dietary supplements are so readily available, they must be safe – a belief enhanced by the liberal use of the word ‘natural’ in association with these products. However, their safety is not necessarily assured, and their combined use with certain drugs can result in serious adverse reactions. Commonly used supplements such as vitamin E, ginseng and gingko biloba have all been touted for their ability to boost certain health aspects, but they also interact with various widely prescribed drugs, causing life-threatening reactions such as reduced blood clotting, psychosis, hypoglycaemia and even coma. It is not just adverse reactions that are of concern when combining supplements and drugs. Interactions can also reduce a drug’s effectiveness, such as the interaction seen between St. John’s wort and oral contraceptive pills. Consumers should always think carefully when choosing dietary supplements, especially those who are taking medications. The combination could potentially be lethal – a far cry from the aim of trying to improve your health. Always consult your doctor before taking a supplement or changing your medication regimen.  Wood LG, Garg ML, Gibson PG (2011). A high-fat challenge increases airway inflammation and impairs bronchodilator recovery in asthma. J Allergy Clin Immunol. 127(5). 1133-40.  Gardiner P, Phillips R, Shaughnessy AF (2008). Herbal and dietary supplement-drug interactions in patients with chronic illnesses. Am Fam Physician. 77(1). 73-8.  Murphy PA, Kern SE, Stanczyk FZ, Westhoff CL (2005). Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding. Contraception. 71(6). 402-8.