Vitamins and Minerals, How Much to Take?

by Herbert C. Mansmann, Jr. M.D.

In 1990, Sheldon Saul Hendler, M.D., Ph.D., a biochemist at the University of California, San Diego, wrote “Although consumption of the so-called well-balanced diets still thought by some to supply all the vitamins (and minerals) we need in quantities sufficient for the maintenance of good health, there are many situations that place people at an increased risk for vitamin (and mineral) insufficiency (deficiency) states.

Among those at risk are alcoholics, people on low-calore diets, pregnant women, the elderly in general, surgical patients, users of certain medications and strict vegetarians. Vitamin (and mineral) supplementation is prudent in those and other cases that will be identified in subsequent chapters.”1 Those words in ( ) have been added. The book contains references to cancer prevention, cholesterol control, diabetes, heart diseases, and other chronic disease. All of these depend upon avoidance of, both, free radicals (oxides) and homocysteine.

“The body’s cells use oxygen—oxygen sometimes reacts with body compound—produces highly unstable molecules (reactive)—called free radicals.”3 Free radicals cause tissue damage, and antioxidants prevent this tissue reaction.

Homocysteine is a toxic amino acid that comes from high meat diets, and accumulates when it cannot be denatured in the presence of suboptimal intakes of B vitamins. Antihomocysteines cause the metabolism to progress normally.

There are essential vitamins and minerals in pharmacological doses, which are highlighted in the table, to be taken in order to prevent progression of the diseases. Multivitamins should be taken daily by everyone over 50yr, yet they all contain much lower amounts than required to function as antioxidants and anti-homocysteine. Unfortunately, over the past ten years there has been an explosion in information on the role, both proven and unproved, of vitamins and minerals on both health and disease. These are called micronutrients and are catalysts that get all of the biochemical reactions in the body operational at the optimal speed.

Supplements, theoretically should help, but must not be, considered a substitute for an adequate diet, but they offer both assurance and insurance (prevention) that the individual is getting enough to remain healthy. All deficiencies have a beginning and are silent until overt symptoms develop. This is because we can not read or recognize intracellular events, which is where they do their thing, that is function at the biochemical level. The occurrence of symptoms is nature’s way of waking us up. In addition, food is known to contain multiple essential chemicals that are not available any other way. The list of these substances continues to grow with new research. The main current references 2-4, cited below, all illustrate this point of view extremely well.

In the 5th century Hippocrates described scurvy, in 1662 the cause, no citrus fruit, was described, and in 1928 vitamin C was isolated. This took 14 centuries, a very slow process. No wonder the following seems so slow. The current Recommended Dietary Allowances (RDA) was publish in 19895. Such volumes are National Official Documents, given great importance, the data must be accurate, current, and safe, and they consider efficacy in regard to “cure claims” It has been agreed that the RDA will be replaced with the term Daily Reference Intakes (DRI).2,3 A 1997 report from the evaluation committee set DRIs for calcium, phosphorus, magnesium, vitamin D, and fluoride. In 1998 the eight B vitamins and choline were assigned a new DRI. The committee is currently moving ahead in this process to end up with Volume 11. Included with this released data we now have Tolerable Upper Intake Levels for selected nutrients. All of this is an active dynamic process, which is very slow, slower than the information received from elsewhere. All of this means we will often have current scientific reports and recommendations to consider. Most of all toxicity must be avoided, unless the benefit far out measures the danger.

Vitamins A, beta-carotene, D, E, and K are fat-soluble, and should be taken with fat containing meals. The task of producing this simplification of a great deal of data, generally unavailable, into an organized matter, called for some compromises. References 2,3,4 have been evaluated and crosschecked for all dosage recommendation. This table is for adults, gender has been ignored and the highest value is given in order not to under dose one or the other. Also, some micronutrients have been omitted from the table because most of them seemed less relevant to clinical pharmacological dosing. It should be obvious, that you, the reader, should optimally utilize all of those marked *** and bold, and certainly before one seeks a magic bullet, such as this or that herb. Only one or two herbs have been scientifically studied for efficacy, and it is unknown if they can safely be taken by chronically ill humans for years. This type of proof will take years.

Note: the concentration of 1.0mg equals1,000mcg. The dosages unit, IU, varies with mg., depending on the type of vitamin.

DOSING WITH RECOMMENDED VITAMIN AND MINERAL SUPPLEMENTS

reasons to be taken

recommended vitamins
and
minerals

Normal healthy Adults

patients with cardiovascular or Chronic Dis. and/or over 50 yrs

CAUTIONS AND COMMENTS

RDA

1989

DRI

1998

PHARMACOLOGIC
Dose per day

TOXICITY

OTHER COMMENTS

Vit A

OR

Beta-Carotene

1 mg(RE)*

15 mg

NA**

NA

 

50,000 IU = 30mg

Over 3,000 mg (RE)

Relatively nontoxic6

Prevents night blindness

Antioxidant*** 2-4,6

Vit B1 (Thiamine)

1.5 mg

1.1 mg

<1,000 mg

>1,000 mg

Prevents beriberi

Vit B2 (Riboflavin)

1.7 mg

NA

100-500 mg

Not reported

 

Vit B3 (Niacin)

20 mg

NA

1,500-3,000 mg

3-9,000 mg

Prevents pellagra

Vit B6 (Pyridoxine)

1.7 mg

1.7 mg

50-100 mg

Do not take 2 hrs before or after a pharmacologic dose of Vit C.

Mild neurological tingling in some when dose over 100 mg

Over 2,000 mg develop severe neurological symptoms

Anti-homocysteine*** 7,8

Vit B12 (Cobalamin)

2.0 mcg

2.4 mcg

1,000 mcg.(As a rule of thumb take 200 mcg of B12 per 1,000 mcg [1 mg] of folate.)

Methormin dec. B12 levels12

Do not take with Vit C13

Dietary deficiency in 20% over age 50.

Anti-homocysteine*** 7,8

Vit C (Ascorbic acid)

60 mg

NA

1,000-3,000 mg

Some get diarrhea at 2,000 mg

Prevents scurvy, see Vit B6 be cautious. Antioxidant*** 2-4,6

Vit D (Calciferol)

400 IU

NA

1,000 IU

1 mcg =40 IU

2,000 IU may be toxic6

Needed for Ca. absorption, always take with Ca.

Prevents rickets

 

Vit E (Tocopherol)

10 mg

NA

400-800IU

(1 IU=1 mg)

2,000 IU safe 5,000 IU toxic

Antioxidant*** 2-4,6

57% decrease in nuclear cataracts11

Folacin (Folic acid)

400 mcg

400 mcg

1000 mcg

5,000 mcg ( 5mg) OK

High doses may obscure B12 diagnosis

Anti-homocysteine***.7,8

Calcium (Ca)

1,200 mg

1,300 mg

1,500 mg

2,500 mg safe

Avoid Dolomite which contain toxic medals

Add 400 IU of VitD, Ca impairs Fe and Zn absorption.

High doses inhibit Magnesium absorption

Copper (Cu)

3 mg

NA

 

 

Absorption inhibited by 100 mg Zn/D

Magnesium (Mg)

300 mg

(6 mg for

every 2.2 lb)9

400 mg

750-5,000 mg (Increase dose very slowly to establish both it’s tolerance and obtain relief of symptoms.)

High oral doses may saturate the ability to absorb more and cause temporary diarrhea .

Nature’s laxative and Ca Channel Blocker Take 1 mg. of Mg to 2-3 mg. of Ca (Exp. 1,500mg of Ca requires at least 500mg Mg.)

Antioxidant*** 10

Selenium (Se)

70 mcg

NA

200 mcg

400 mcg

 

Zinc (Zn)

15 mg

NA

50-100 mg

 

If take more, then add copper supplement.

* RF is retnol equivalent, **NA means not available, ***At least all of these should be taken if you are ill or over 50.

References

  1. Hendler, S.S.; The Doctors Vitamin and Mineral Encyclopedia. Simon & Schuster, 1990.
  2. Shils, M.E. et al. Modern Nutrition in Health and Disease, 9th Ed., Williams & Wilkins, Baltimore, 1998, 1951pp. A COMPREHENSIVE REFERANCE SOURCE
  3. Whitney E.N., Rollfes, S.R. Understanding Nutrition, 8th Ed., West/Wadsworth Belmont, CA., 1999, 647pp. Plus 11 Appendixes (about 150pps.) Presents the core information of an introductory nutrition course.
  4. Spallholz, J.E., et al., 2nd Ed.. Nutrition, Chemistry and Biology 2nd Ed., CRC Press, 1999, 345pp. An excellent overview.
  5. National Research Council, Recommended Dietary Allowances, 10th Ed. National Academic Press, 1989
  6. Antioxidant Therapy, Wise Way to Stop Illness Before It Starts. Bottom Line HEALTH, 1998 Nov.:p3-5.
  7. McCully, K. Why Homocysteine is More Important Than Cholesterol. Bottom Line Health, 1997; Nov. p.1. (Meat, which is high in methionine which is converted to homocysteine, in those with low blood levels of Vit.B6, Vit.B12 and Folic acid result in high blood levels of Homocysteine.)
  8. Graham, I. Et al. Homocysteine Metabolism From Basic Science to Clinical Medicine. Kluwer Academic Publ. 1997, pp279.
  9. Herbert, V. Blood, 1996, Suppl. P1955.
  10. Abstract in Bottom Line Health 1/99, p1 of research by M.C. Leske and publish in the journal Ophthalmology
  11. Seelig, M. S., Magnesium Deficiency in the Pathogenesis of Disease, Pleum Medical Book Company, New York, 1980
  12. Weglicki, W.B., et el. Antioxidants and the cardiomyopathy of Mg-deficiency. Am. J. Cardiovas. Pathol., 1992: 4:210-215.
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