Many people have asked what my thoughts are on taking vitamins and supplements. Although I support the use of vitamins, supplements, and other forms of herbal remedies, I advocate for these when we need physical, mental, or emotional support. But, if we are perfectly healthy, I do not believe we need supplements, including vitamins, in the forms of a pill.
Instead, I believe we should get them through our food. If we consume a colorful diet, where are at least half consists of fruits and vegetables, albeit mostly vegetables, we should be getting the vitamins we require. That is a gross generalization, and I repeat, one that should work if we are generally healthy. If we have a deficiency, then of course it is important we supplement.
I understand that our lifestyles make it difficult to keep a healthy diet where we eat mostly plant-based foods. Thus, the only alternative is to take vitamins. If that is the case, I will share what we need to know about vitamins.
Vitamin Classification: Fat-Soluble or Water-Soluble
Vitamins are classified as either fat-soluble or water-soluble, depending on how they are absorbed and transported in the body. Fat-soluble vitamins are associated with body lipids or fat, and are easily stored in the body. Water-soluble vitamins are associated with water, and are easily transported throughout the body (Schlenker & Roth, 2011).
Water-soluble vitamins are absorbed easily and transported readily in the body. They include the B complex family and Vitamin C or ascorbic acid. They are affected by any process that affects their ability to be solvents in water, such as heat and radiation that can come from boiling, microwaving, or cooking the food they are found in (Mahan, Escott-Stump, & Raymond, 2012).
For example, vitamin C is found in citrus fruits, watermelon, strawberries, leafy greens, and tomatoes. It is an antioxidant that stabilizes free radicals, but this same quality means they oxidize quickly, which occurs if they are exposed to air or if they are heated. Thus, it is best to consume foods with vitamin C as fresh and raw as possible.
Another example is thiamin. Thiamin is also destroyed through heat, oxidation, and radiation, but not in all cases. Thiamin found in meats, fish, and beans can withstand heat if they are mixed in acid. But, thiamin in dairy foods, eggs, and green leafy vegetables are stable in heat.
Water-soluble vitamins are absorbed relatively simply into the body, and are not stored in organs or glands. Instead, they need to be consumed regularly.
Unused or excess consumption usually gets excreted in urine. Thus, use of diuretics is not recommended as this increases the rate in which urine is excreted, and thus increases the rate of vitamin loss. Use of antacids can also accelerate vitamin loss or decrease its absorption.
Fat-soluble vitamins are absorbed passively and transported with fats; they can be stored in the body, but if consumed or stored in excess they can become toxic; and they are excreted from the body in feces (Mahan, Escott-Stump, & Raymond, 2012).
Fat-soluble vitamins include vitamins A, D, E, and K, and they are mostly found in meats, dairy fats, eggs, and green leafy vegetables. They are usually stable when heated or cooked, but can be destroyed when they are dried out, over-cooked, go rancid, or exposed to ultraviolet radiation.
For example, vitamin A is found in liver, kidney, milk fat, egg yolks, yellow and green leafy vegetables, apricots, and peaches. They are ok when cooked, but are destroyed when they are dried and burned.
When consumed at very high levels, some fat-soluble vitamins can cause toxicity. Since they are stored in body organs and tissues, they can cause damage to these. Too much vitamin A causes liver damage, and too much vitamin D can cause calcification deposits in the body.
How Vitamins & Drugs Interact
Drugs can affect the absorption of vitamins, and decrease the body’s ability to absorb the nutrients. For instance, when taken for a long period of time, cimetidine, a drug used to prevent gastric secretions, can decrease the absorption of vitamins B12, thiamin, and iron.
Drugs can also bind to vitamins and cause malabsorption or prevent the absorption of vitamins. Questran, an anti-hyperlipidemic, binds to fat-soluble vitamins such as vitamins A, D, E, and K and prevents them from being absorbed in the gastrointestinal tract. Drinking too much alcohol can cause malabsorption of thiamin and folic acid.
Vitamins can enhance the absorption of certain drugs. For instance, vitamin C enhances the absorption of iron supplements, and it is recommended for iron to be taken with a good source of vitamin C, such as orange juice.
Vitamins can affect the effectiveness of a drug. For example, the anticonvulsive drug Dilantin is affected when large doses of folate are consumed.
Megadose vitamin therapy is a practice people get into by supplementing their diet with too many vitamins, or when relying on vitamin supplements as their source for nutrients, instead of relying on natural foods such as produce, grains, meats, nuts, seeds, and dairy.
Megadose vitamin therapy is the result of aggressive marketing and promotion from supplement companies. Vitamins are often combined into multi-vitamin supplements that are not always absorbed well in the body, since different vitamins interact with each other and with other food items, thus affective their bioavailability.
Also, it is important not to consume excessive amounts of certain vitamins. As mentioned, too much vitamin A can cause liver damage, and may also result in vomiting, headaches, joint pain, hardening of bones, hair loss, and jaundice.
There are a few exceptions. Vitamin C in excessive amounts is recommended when people are suffering from colds. The excess vitamin is excreted in the urine. However, vitamin C can interact with some drugs and chemotherapy, and should thus be used with caution in those situations.
Vitamin E is another exception, and currently there is no known adverse effect or toxicity caused by excess vitamin E consumption. However, more than 1,000 mg of vitamin E can interference with blood clotting, and should be used with caution by those taking anti-clotting medication.
Drugs, vitamins, and other supplements are valuable in treatment, but it is important to know when to consume each to maximize their effectiveness and minimize potential harmful effects. It is also important to know how to combine drug, vitamin, and supplement intake with food in order to get the maximum benefit of both. Whenever taking any type of vitamin, supplement, or medication speak to a healthcare provider to understand all of its effects and consequences.
Mahan, L. K., Escott-Stump, S., & Raymond, J. L. (2012). Krause’s Food and The Nutrition Care Process (13th ed.). St. Louis, MO: Elsevier Saunders.
Schlenker, E. D. & Roth, S. L. (2011). Williams’ Essentials of Nutrition and Diet Therapy- Revised Reprint (10th ed.). St. Louis, MO: Elsevier Mosby.