5/13/2016

AdverseEffectsOfLongTermSupplementIntake

AdverseEffectsOfLongTermSupplementIntake
AdverseEffectsOfLongTermAndExcessiveSupplementIntake
May9,20167:43AM
5MinRead

Aswithmostthingsinlife,toomuchofagoodthingcanbeharmful.Thatisalsotrueforvitaminsand
minerals.TheNationalInstitutesofHealth(NIH)establishesTolerableUpperLevelsofIntakeformost
oftheessentialvitaminsandminerals.
However,productsmarkedasdietarysupplementsarenotheldtothesamestandardsasprescription
medicationsandmaycontainmorethanthoselevels.

ChooseYourDietarySupplementsWisely
TheNIHhasnotedthatsomemultivitaminscontainlevelsofvitaminsandmineralsthataresubstantially
higherthantheestablishedtolerableupperlevelsofintake.
Thisisespeciallyworrisomebecauseofaddedintakefromfortifiedfoodssuchasbreakfastcereals,and
fortifiedbeveragessuchasvitaminwaterandenergydrinks.
Onestudyofchildrenshowedthatchildrenwhotakeageneralmultivitaminareoftenabovetheupper
tolerableintakelevelforiron,zinc,copper,selenium,folicacidandvitaminAwhilestillhavinginsufficient
levelsofvitaminDandcalcium.1
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AdverseEffectsOfLongTermSupplementIntake

Anotherstudybyacademicpharmacistsshowedthatmorethanhalftooksupplements,butfewofthe
supplementstheytookwereinthetoptenmostcommonsupplements.2
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OtherNIHPublicAccessstudieshaveshownthatmultivitaminusehaslittlebenefitfordisease
preventionormortality.3TheNIHhasstatedAlthoughmultivitaminsdonotappeartoreduceoverall
chronicdiseaserisk,severalnutrientsinmultivitaminsmightbenefitcertainpopulationgroups.Low
bonedensityisoneofthegroupsidentifiedbytheNIH.
Thismeansyoushouldselectyoursupplementsforspecificpurposes.Italsomeansthatyoushould
avoidexcessivevitaminsandmineralsthatareinmanysupplements.
Onereasonforexcessivesupplementsisthatthegeneralpublicbelievesthatmoreisbetterandthis
leadstoexcessvitaminsformarketingpurposes.
Anotherreasonisthatsomevitaminsandmineralsarecheaperandeasiertoprocessintoapillthan
othervitaminsandmineralsthatareequallyessential.
Thismayleadtoanimbalanceofnecessaryvitaminsandmineralswherethecheapestonesare
providedinexcesswhilethemoreexpensiveonesarenotincludedinthemultivitamintabletsor
capsules.Perhapsthisiswhyacademicpharmacistsaremoreselectiveintheirchoices.

AdverseEffectsOfExcessiveLongTermIntake
TheTolerableUpperIntakeLevelrepresentstheleveloftotaldailyintakethatmayproduceadverse
effectswhentakenonalongtermbasisfromthecombinationoffoods,fortifiedfoods,beverages,and
supplements.
Someofthecommonupperintakelevelsfordifferentvitamins/mineralsalongwiththeiradverseeffects
ofexcessivelongtermintakearelistedbelow,butmoreorlessmayberecommendedduring
pregnancy,whendeficiencieshavebeenidentified,orforsomechronicdiseases.

VitaminA
UpperSafeIntakeLevel:3,000mcg
Excessintakemaycauseheadaches,nausea,blurredvision,liverproblems,andincreasedfracturerisk.

VitaminB6
UpperSafeIntakeLevel:100mg
Excessintakemaycausesensitivitytolight,nausea,heartburn,andtinglingnerves.
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Folate/Folicacid
UpperSafeIntakeLevel:1,000mcg
ExcessintakemaycauseincreasedriskofcertaincancersornerveproblemswhenvitaminB12levels
arelow.

Niacin
UpperSafeIntakeLevel:35mg
Excessintakemaycauseheadaches,itching,stomachproblems,andflushing.Largedosesmay
increasetheriskofliverdamageandgout.

VitaminC
UpperSafeIntakeLevel:2,000mg.
Excessintakecanincreasebleeding,contributetokidneystones,decreaseironabsorption,orcauseGI
(gastrointestinal)distress.

Calcium
UpperSafeIntakeLevel:2,000mg
Excessintakemayincreasetheriskoffractures,constipationandmayinterferewithironandzinc
intake.

VitaminD
UpperSafeIntakeLevel:4,000IU
Excessintakemaydecreasebonedensityandcauseexcessivecalciumlevels,interferewithmuscleand
brainfunctionalongwithpossiblekidneyandintestinalproblems.

VitaminE
UpperSafeIntakeLevel:1,000mg
ExcessivevitaminEisassociatedwithexcessivebleeding,increasedmortality,andincreasedriskof
prostatecancer.

Iron
UpperSafeIntakeLevel:45mg
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ExcessintakeisassociatedwithGIproblems,decreasedzincabsorption,andincreasedmortality.

VitaminK
UpperSafeIntakeLevel:Noupperlevelhasbeenidentifiedascausingproblemsforthisnecessary
vitamin.
PeopletakingCoumadinasabloodthinnerneedtoavoidvitaminKsupplements.Thereareseveral
formsofvitaminKandtheMK7typethatseemstobemorebeneficialforboneandbloodvessels.

Selenium
UpperSafeIntakeLevel:400mcg
ExcessintakecancauseGIproblems,skinrashes,hairandnaillossorbrittleness,andincreasedriskof
prostatecancer.Brazilnutshaveveryhighseleniumlevelsofapproximately75mcgpernut.

Zinc
UpperSafeIntakeLevel:40mg
Excessintakeisassociatedwithurinaryproblems,nausea,diarrhea,abdominalcramping,copper
deficiency,andincreasedmortality.

Manganese
UpperSafeIntakeLevel:11mg
ExcessintakeisassociatedwithliverdiseaseandneurologicalproblemssuchasParkinsonsdisease.
Insummary,youneedtocheckyourtotalintakeofvitaminsandmineralsfromallsourcestomakesure
youarebelowtheTolerableUpperIntakeLevel.
Specificallydevelopedsupplementsthatarenotinthetoptenmostpopularmultivitaminsmaybebetter
thanrelyingonthebeliefthatmoreisbetter.
References1.Bailey,ReganL.,VictorL.Fulgoni,DebraR.Keast,CindyV.Lentino,andJohannaT.
Dwyer.Dodietarysupplementsimprovemicronutrientsufficiencyinchildrenandadolescents?.The
Journalofpediatrics161,no.5(2012):837842.2.Murphy,MichaelS.,AlbertI.Wertheimer,andElaine
D.Mackowiak.Dietarysupplementuseamongacademicpharmacists.PharmacyPractice(Internet)5,
no.1(2007):3135.3.Wang,JianBing,ChristianC.Abnet,JinHuFan,YouLinQiao,andPhilipR.
Taylor.26YearFollowupoftheRandomizedLinxianDysplasiaNutritionInterventionTrial:NoEffectof
MultivitaminSupplementationonMortality.JAMAinternalmedicine173,no.13(2013):1259.
FURTHERREADING
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Expert
CharlesT.ChadPrice,MDisProfessorofFloridaStateUniversityCollegeofMedicineandwasa
practicingpediatricorthopedicsurgeonfor34years.Dr.PriceisratedasOneofAmerica'sTopDoctors.
HereceivedaB.SdegreefromEmoryUniversityinAtlantawherehewasinductedintothePhiBeta
Kappahonoraryscholasticsociety.HegraduatedfromBaylorCollegeofMedicineinHoustonand
completedhisorthopedicsurgeryresidencyattheUniversityofFlorida.Heisanauthorofover70
scientificpapers,20textbookchapters,andthreebooksontopicsincludingbonelengthening,fracture
healing,artificialbonegraftingandotherresearchtopics.In2013hebecamecertifiedasaSports
NutritionistbytheAmericanSportsandFitnessAssociation.

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