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Vitamin Pills: Popping Too Many?

Vitamin Supplements Safe, but Multis Matter Most

By Jeanie Lerche Davis WebMD Feature Reviewed By Brunilda Nazario, MD
on Thursday, June 19, 2003 Email to a friend > Printer-friendly
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A morning multivitamin. A couple of E's. Maybe some C. A protein shake
for lunch. A calcium pill or two, later in the day. We've come a long
way since our Flintstones days. But are Americans overdoing it?

It's true, vitamin-fortified foods are flying off store shelves. Even
orange juice comes with calcium and vitamin D. Energy bars,
meal-replacement drinks, protein shakes, cereal bars, cereal itself --
all claim lots of vitamins and minerals, up to 100% of the recommended
daily allowance (RDA).

Then, too, specially blended multivitamins -- with hot new "additives"
such as green tea -- are nearly irresistible to health nuts.

But you do the math: You could be getting up to 500% of the RDA, maybe
more, in one day's time -- up to five times what your body needs. Are we
toting up toxic levels of vitamins? Or throwing our money away?

Experts Weigh In

Chris Rosenbloom, PhD, RD, professor of nutrition at Ge****a State
University in Atlanta, counsels plenty of people who are overdoing it.

"If you're eating two energy bars a day, plus a protein shake that is
vitamin fortified, plus taking vitamin supplements, you don't need all
that," says Rosenbloom.

But most people still aren't getting the right vitamins despite their
best efforts, says Jeffrey Blumberg, PhD, professor of nutrition at
Tufts University in Boston. "Most people need a multivitamin as
'insurance.' Everybody needs to eat more healthfully. While you're
trying to get there, take supplements."

In fact, many people don't know what they're taking, Rosenbloom says.
"They're picking up OJ at the store, and they don't know what's in it --
is it calcium-fortified, they don't know. People are taking vitamin C
supplements but don't know how much."

A Tidbit of Data

A couple of years ago, the Institute of Medicine issued a report listing
"tolerable upper intake level" for all vitamins and minerals -- the
maximum safe amount that anyone should take.

Vitamin A

The upper tolerable limit for adults is 10,000 IU for vitamin A. You get
it from animal foods, fish, and dairy products. Also, beta-carotene
(from orange and yellow veggies) gets converted to vitamin A in the
body. "But the body is smart enough that it doesn't convert all that to
vitamin A," Rosenbloom explains.

If you're taking a multivitamin that contains 5,000 IU, plus getting
A-fortified foods in your diet, plus eating foods that contain vitamin
A, you're probably OK. "It's the supplements we worry about. It's easy
to overdo it with pills," she says.

Vitamin C

"Most people think it's fine to take as much as they want," says
Rosenbloom. "I know people who take 10,000 mg a day." However, the upper
tolerable limit is 2,000 mg a day. "People at risk for kidney stones can
increase that risk; people also can get diarrhea. Some people have
complained of food poisoning, but it turned out they had taken too much
vitamin C. People just aren't aware how potent these vitamin supplements
are."

Vitamin D

"This can be tricky because we need some, and as we get older we need
more," Rosenbloom tells WebMD. "But the risk is that we get too much,
which can actually cause calcium to leach out of your bones." Vitamin D
is found in some calcium supplements; some orange juice products are
fortified with vitamin D. If you're somebody who can't drink dairy,
getting vitamin-fortified orange juice makes sense. "But if you do drink
diary, and then you take a supplement, it's that layering that I get
concerned about," she says.

Vitamin B-6

This is a water-soluble vitamin, which means you just pee out the
excess, says Rosenbloom. The upper tolerable limit is 100 mg day, and in
pill form it's easy to get that much. "In high doses, people have
problems with temporary nerve damage -- they lose feeling in their hands
and feet," she tells WebMD.

Fif**** years ago, women were told to take megadoses to help with
depression and PMS, but that's been debunked, she says.

Vitamin E

People focus on E to prevent Alzheimer's, heart disease, macular
degeneration, cancer, "the list goes on," says Blumberg. The upper
tolerable level is 1,000 IU; the RDA is 30 IU. "There is no way to get
an overdose from diet or fortified foods. In an Alzheimer's study,
people took 2,000 IU for four years and didn't have any adverse effects.
In another study, people took 800 IU for six years, with no adverse
effects, he says.

Read the Label

Pay attention to food labels, says Rosenbloom. "When you're grocery
shopping, picking up an energy bar or breakfast cereal, look at the
supplement facts panel. If you see 100% of RDA, you may not need a
multivitamin supplement."

For a small fee, a nutritionist can evaluate your diet for deficiencies.
Also, some online programs provide the same service.

"People are often very surprised when they see the nutrients they are
getting and what they're not," says Rosenbloom. "Maybe they need a
calcium supplement, maybe your vitamin C is low if you don't eat any
citrus."

Won't Prevent the Inevitable

Blumberg's prudent advice: "Take a multivitamin. Take a calcium
supplement, if you don't drink much milk. If you're taking medicine that
interferes with nutrient absorption, if you're an older person whose
calorie intake is low, if you're an athlete, if you're pregnant -- all
of those are good reasons to take a multivitamin supplement."

Just stay away from those whopper-sized, 25,000 mg vitamin A pills, he
says.

"By and large, nutrient supplements -- vitamins, minerals -- are
enormously safe," Blumberg says. "Even if you drink a gallon of OJ a
day, eat fruits and vegetables, then take 1,000 mg of vitamin C, you're
not going to even get close to toxicity."

Published June 19, 2003.

http://my.webmd.com/content/article/67/79958.htm