In 2018, a University of Adelaide forensic pathologist in cautions that potentially harmful substances found in herbal medicines may be playing a bigger role in deaths of “health tourists” than previously thought.

Professor Roger Byard is calling for closer checks during post-mortems for the presence of drugs and adulterants that originate from herbal remedies. “There is a possibility that harmful materials found in herbal medicines are either contributing to, or causing, deaths of overseas travelers,” says Professor Byard. “These factors should be considered in all medical and legal cases involving recent overseas travel, particularly to Asian destinations.”

HEALTH + WELLNESS TOURISM

As part of health and wellness tourism, Western travelers to many Asian countries now often visit herbal centers. Free health checks may be performed at these centers and herbal products are offered for sale. They offer hope to a growing number of people looking for a cure for their health problems.

Studies have found some herbal remedies have been adulterated with approved or banned drugs and even toxic heavy metals.

“This type of health tourism is based upon learning about and consuming traditional medicinal herbs and is an important part of the worldwide medical tourism industry,” says Professor Byard. “Patients wrongly believe that they are being treated without using harmful chemicals or drugs.”

FOREIGN SUBSTANCES CAN RANGE OF SIDE EFFECTS

Adulterants have been linked to a range of side effects of varying severity including hypertension, heart problems, psychiatric disorders and in some instances even deaths. “The composition of many of these products is uncertain, there may be contaminants and pharmaceutical additives, and their interaction with prescription medications is unpredictable,” says Professor Byard. “However, the potential role and impact of herbal medicines, and possible adulterants within them, is usually not considered in medico-legal cases. Forensic facilities may be missing the presence of harmful or toxic substances when carrying out post mortem assessments not because the substances aren’t there but because pathologists may not be looking for them. When considering cases in which a person has died after taking herbal medicines sourced from overseas, forensic pathologists need to take extra care to consider the possibility that adulterants have played a role in the person’s demise.”

Nearly 15 percent of all chewing gum varieties sold promise to provide health-enhancing supplements to users – which inspired a team of Penn State researchers to study whether two vitamin-supplemented products were effective at delivering vitamins to the body. Their results validate the concept of gum as an effective delivery system for at least some vitamins.

The 2018 research marks the first time that researchers closely scrutinized vitamin delivery from chewing gum, according to Joshua Lambert, professor of food science in the College of Agricultural Sciences.

Chewing gum – a pleasant habit for many – could be a strategy to help reduce vitamin deficiency around the world, a problem described as an epidemic.

Even in the United States, vitamin deficiency is a serious problem, with nearly 1 in 10 people over the age of one deficient in vitamins B6 and C, according to a recent analysis of the National Health and Nutrition Examination Survey.

To find out if supplemented gum contributes vitamins to chewers’ bodies, researchers had 15 people chew two off-the-shelf supplemented gums and measured the levels of eight vitamins released into their saliva. In a separate experiment on the same subjects, the researchers measured the levels of seven vitamins in their plasma.

The researchers used an identical gum product – minus the vitamin supplements – as a placebo in the study.

Lambert and colleagues found that retinol (A1), thiamine (B1), riboflavin (B2), niacinamide (B3), pyridoxine (B6), folic acid, cyanocobalamin (B12), ascorbic acid (C), and alpha-tocopherol (E) were released into the saliva of study participants who chewed the supplemented gums. After chewing the supplemented gums, study participants’ blood plasma vitamin concentrations, depending on which supplemented gum they chewed, were increased for retinol, by 75 to 96 percent; pyridoxine, 906 to 1,077 percent; ascorbic acid, 64 to 141 percent; and alpha-tocopherol, 418 to 502 percent, compared to the placebo.

For the most part, the research demonstrated that water-soluble vitamins such as vitamins B6 and C were increased in the plasma of participants who chewed supplemented gum compared to participants who chewed the placebo gum.

In supplemented gum chewers, researchers also saw increases in the plasma of several fat-soluble vitamins such as the vitamin-A derivative retinol and the vitamin-E derivative alpha tocopherol – which was the most significant finding of the study, Lambert pointed out. At least for the products tested, the water-soluble vitamins were almost completely extracted from the gum during the process of chewing. The fat-soluble vitamins were not completely released from the gum.

“Improving the release of fat-soluble vitamins from the gum base is an area for future development for the manufacturer,” he said.

Lambert offered one caution about the findings, which were published online this month in the Journal of Functional Foods: “This study was done in an acute setting – for a day we have shown that chewing supplemented gum bumps up vitamin levels in blood plasma,” he said. “But we haven’t shown that this will elevate plasma levels for vitamins long-term. Ideally, that would be the next study. Enroll people who have some level of deficiency for some of the vitamins in supplemented gum and have them chew it regularly for a month to see if that raises levels of the vitamins in their blood.”

“We meticulously evaluated the body of scientific evidence,” said study lead author Joonseok Kim, M.D., assistant professor of cardiology in the Department of Medicine at the University of Alabama at Birmingham. “We found no clinical benefit of multivitamin and mineral use to prevent heart attacks, strokes or cardiovascular death.”

The research team performed a “meta-analysis,” putting together the results from 18 individual published studies, including randomized controlled trials and prospective cohort studies, totaling more than 2 million participants and having an average of 12 years of follow-up. They found no association between taking multivitamin and mineral supplements and a lower risk of death from cardiovascular diseases.

“It has been exceptionally difficult to convince people, including nutritional researchers, to acknowledge that multivitamin and mineral supplements don’t prevent cardiovascular diseases,” said Kim. “I hope our study findings help decrease the hype around multivitamin and mineral supplements and encourage people to use proven methods to reduce their risk of cardiovascular diseases – such as eating more fruits and vegetables, exercising and avoiding tobacco.”

According to the United States Food and Drug Administration, unlike drugs, there are no provisions in the law for the agency to “approve” dietary supplements for safety or effectiveness before they reach the consumer, nor can the product’s label make health claims to diagnose, cure, mitigate, treat or prevent a disease. As many as 30 percent of Americans use multivitamin and mineral supplements, with the global nutritional supplement industry expected to reach $278 billion by 2024.

Controversy about the effectiveness of multivitamin and mineral supplements to prevent cardiovascular diseases has been going on for years, despite numerous well-conducted research studies suggesting they don’t help. The authors set out to combine the results from previously published scientific studies to help clarify the topic.

“Although multivitamin and mineral supplements taken in moderation rarely cause direct harm, we urge people to protect their heart health by understanding their individual risk for heart disease and stroke and working with a healthcare provider to create a plan that uses proven measures to reduce risk. These include a heart-healthy diet, exercise, tobacco cessation, controlling blood pressure and unhealthy cholesterol levels, and when needed, medical treatment,” Kim said.

The American Heart Association does not recommend using multivitamin or mineral supplements to prevent cardiovascular diseases.

“Eat a healthy diet for a healthy heart and a long, healthy life,” said Eduardo Sanchez, M.D., the American Heart Association’s chief medical officer for prevention and chief of the Association’s Centers for Health Metrics and Evaluation, who was not a part of this study. “There’s just no substitute for a balanced, nutritious diet with more fruits and vegetables that limits excess calories, saturated fat, trans fat, sodium, sugar and dietary cholesterol.”

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit www.heart.org or call any of our offices around the country.

The finding, from researchers at St. Michael’s Hospital, in Toronto, and the University of Toronto, was published in the Journal of the American College of Cardiology.

According to a news release from St. Michael’s, the systematic review of existing data and single randomized control trials published in English from January 2012 to October 2017 found that multivitamins, vitamin D, calcium and vitamin C – the most common supplements – showed no advantage or added risk in the prevention of cardiovascular disease, heart attack, stroke or premature death. Generally, vitamin and mineral supplements are taken to add to nutrients that are found in food.

“We were surprised to find so few positive effects of the most common supplements that people consume,” said Dr. David Jenkins, the study’s lead author. Jenkins is Director of the Clinical Nutrition and Risk Factor Modification Centre, scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and university professor in the Department of Nutrition Sciences and Medicine at the University of Toronto. “Our review found that if you want to use multivitamins, vitamin D, calcium or vitamin C, it does no harm – but there is no apparent advantage either.”

The study found folic acid alone and B-vitamins with folic acid may reduce cardiovascular disease and stroke. Meanwhile, niacin and antioxidants showed a very small effect that might signify an increased risk of death from any cause.

“These findings suggest that people should be conscious of the supplements they’re taking and ensure they’re applicable to the specific vitamin or mineral deficiencies they have been advised of by their healthcare provider,” Jenkins said.

His team reviewed supplement data that included A, B1, B2, B3 (niacin), B6, B9 (folic acid), C, D and E; and β-carotene; calcium; iron; zinc; magnesium; and selenium. The term ‘multivitamin’ in this review was used to describe supplements that include most vitamins and minerals, rather than a select few.

“In the absence of significant positive data – apart from folic acid’s potential reduction in the risk of stroke and heart disease – it’s most beneficial to rely on a healthy diet to get your fill of vitamins and minerals,” Jenkins said. “So far, no research on supplements has shown us anything better than healthy servings of less processed plant foods including vegetables, fruits and nuts.”

Such a lack could be a serious public health concern, in light of the millions of people who have this condition that’s often related to obesity.

A study published in the American Journal of Clinical Nutrition also made it clear that conventional tests to measure vitamin E levels in the blood may have limited accuracy compared to tests made in research laboratories, to the point that conventional tests can actually mask an underlying problem.

Vitamin E – one of the more difficult micronutrients to obtain by dietary means – is an antioxidant important for cell protection. It also affects gene expression, immune function, aids in repair of wounds and the damage of atherosclerosis, is important for vision and neurologic function, and largely prevents fat from going rancid.

Nutrition surveys have estimated that 92 percent of men and 96 percent of women in the United States fail to get an adequate daily intake of vitamin E in their diet. It is found at high levels in almonds, wheat germ, various seeds and oils, and at much lower levels in some vegetables and salad greens, such as spinach and kale.

The study was conducted by researchers in the Linus Pauling Institute at Oregon State University and the Human Nutrition Program at The Ohio State University, as a double-blind, crossover clinical trial focusing on vitamin E levels in people with metabolic syndrome.

“The research showed that people with metabolic syndrome need about 30-50 percent more vitamin E than those who are generally healthy,” said Maret Traber, a professor in the OSU College of Public Health and Human Sciences, and Ava Helen Pauling Professor in the Linus Pauling Institute.

“In previous work we showed that people with metabolic syndrome had lower bioavailability of vitamin E. Our current work uses a novel approach to measure how much vitamin E the body needs. This study clearly demonstrates that people with metabolic syndrome need a higher intake of this vitamin.”

More than 30 percent of the American public are obese, and more than 25 percent of the adults in the United States meet the criteria for metabolic syndrome, putting them at significantly increased risk for cardiovascular disease and type-2 diabetes – primary causes of death in the developed world.

That syndrome is defined by diagnosis of three or more of several conditions, including abdominal obesity, elevated lipids, high blood pressure, pro-inflammatory state, a pro-thrombotic state and insulin resistance or impaired glucose tolerance.

This research, for the first time, also clearly outlined a flaw with conventional approaches to measuring vitamin E.

By “labeling” vitamin E with deuterium, a stable isotope of hydrogen, scientists were able to measure the amount of the micronutrient that was eliminated by the body, compared to the intake. The advanced research laboratory tests, which are not available to the general public, showed that people with metabolic syndrome retained 30-50 percent more vitamin E than healthy people – showing that they needed it. When the body doesn’t need vitamin E, the excess is excreted.

But in the group with metabolic syndrome, even as their tissues were taking up and retaining the needed vitamin E, their blood levels by conventional measurement appeared about the same as those of a normal, healthy person.

“We’ve discovered that vitamin E levels often look normal in the blood, because this micronutrient is attracted to high cholesterol and fat,” Traber said. “So vitamin E can stay at higher levels in the circulatory system and give the illusion of adequate levels, even as tissues are deficient.

“This basically means that conventional vitamin E blood tests as they are now being done are useless.”

The findings support the conclusion that people with metabolic syndrome have higher levels of oxidative and inflammatory stress, scientists said in their conclusion, and require more antioxidants such as vitamins E as a result.

A release from the academy explains that cerebrovascular disease is a group of disorders that affect blood flow in the brain. These diseases, including stroke, are the fifth leading cause of death in the United States and increase the risk of developing dementia.

The release quotes study author Silke Kern, MD, PhD with the University of Gothenburg in Sweden, as saying, “Osteoporosis is a common problem in the elderly. Because calcium deficiency contributes to osteoporosis, daily calcium intake of 1000 to 1200 mg is recommended. Getting this recommended amount through diet alone can be difficult, so calcium supplements are widely used. Recently, however, the use of supplements and their effect on health has been questioned.”

The study involved 700 dementia-free women between the ages of 70 and 92 who were followed for five years. Participants took a variety of tests at the beginning and end of the study, including tests of memory and thinking skills. A CT brain scan was performed in 447 participants at the start of the study.

Scientists also looked at the use of calcium supplements in the participants and whether they were diagnosed with dementia over the course of the study. A total of 98 women were taking calcium supplements at the start of the study and 54 women had already experienced a stroke. During the study, 54 more women had strokes, and 59 women developed dementia. Among the women who had CT scans, 71 percent had lesions on their brains’ white matter, which is a marker for cerebrovascular disease.

The study found that the women who were treated with calcium supplements were twice as likely to develop dementia than women who did not take supplements. But when the researchers further analyzed the data, they found that the increased risk was only among women with cerebrovascular disease. Women with a history of stroke who took supplements had a nearly seven times increased risk of developing dementia than women with a history of stroke who did not take calcium supplements. Women with white matter lesions who took supplements were three times as likely to develop dementia as women who had white matter lesions and did not take supplements. Women without a history of stroke or women without white matter lesions had no increased risk when taking calcium supplements.

Overall, 14 out of 98 women who took supplements developed dementia, or 14 percent, compared to 45 out of 602 women who did not take supplements, or 8 percent. A total of six out of 15 women with a history of stroke who took supplements developed dementia, compared to 12 out of 93 women with a history of stroke who did not take supplements. Among the women with no history of stroke, 18 out of 83 who took supplements developed dementia, compared to 33 out of the 509 who did not take supplements.

“It is important to note that our study is observational, so we cannot assume that calcium supplements cause dementia,” said Kern. The author also noted that the study was small and results cannot be generalized to the overall population, and additional studies are needed to confirm the findings.

Kern noted that calcium from food affects the body differently than calcium from supplements and appears to be safe or even protective against vascular problems.

Magnesium, a mineral found abundantly in the body, is naturally present in many foods, available as a dietary supplement, and an ingredient in medications including laxatives and antacids. Magnesium is an important component of key enzyme systems in the body, including protein synthesis and muscle and nerve function, as well as regulation of blood glucose levels and blood pressure.

Why is Magnesium important/necessary? (health effects of vitamin/supplement on body)

It is important to note that magnesium is required for energy production, assisting with key bodily processes known as oxidative phosphorylation and glycolysis. As well, magnesium contributes to the structural development of bone and is required for the synthesis of DNA, RNA, and the antioxidant glutathione. Finally, magnesium plays a role in the active transport of calcium and potassium ions across cell membranes—a process that is key to conduction of nerve impulses, contraction of muscle fibers, and normal rhythm of the heart.

What Magnesium does for your Body?

Many experts agree that magnesium may be the most overlooked mineral. No one has yet popularized a simple way to remember it, in the way that we usually associate potassium with bananas, calcium with bone health, and sodium with blood pressure. Magnesium, however, is a particularly useful mineral that many doctors, nutritionists, and researchers consider to be possibly the most important nutrient for your overall health.

Magnesium plays an essential role in hundreds of chemical reactions in your body, from helping you maintain your energy levels, allowing you to relax, and sustaining your heart and blood vessel health. And most people do not get enough magnesium on a daily basis.

So, what does magnesium do for your body? What is it good for?

• It is commonly used in over-the-counter laxative medicines as a means to alleviate constipation
• Magnesium is found in antacid medications used to relieve heartburn, acid indigestion, and upset stomach
• Magnesium promotes restful sleep and acts as a calming agent. It is excellent for reducing insomnia
• It also improves brain function and fights depression
• Magnesium is also a natural calcium-channel blocker, which may be key to regulating healthy blood pressure
• It helps decrease inflammation, which can beneficially impact many bodily systems
• Healthy magnesium levels help lower cortisol, the stress hormone, which helps you return to a more relaxed state faster
• Together with calcium, magnesium is key to the maintaining bone health
• It helps the heart muscle function properly and also protects blood vessels, thereby helping your body fight heart disease
• Due to its natural ability to act as a blood thinner, experts believe that magnesium may prove key to the prevention of serious cardiovascular complications, including heart attack and stroke

How Much Magnesium Do I Need?
The exact amount of magnesium you should consume each day depends on your age, gender, diet, and individual health-related factors, including pregnancy and lactation. According to the National Institutes of Health (NIH), the average daily U.S. Recommended Dietary Allowance (RDA) of magnesium, as consumed from foods, is:

So, what does this mean for you? See the “What foods have Magnesium” section for more information.

What Happens If You Don’t Get Enough Magnesium (Signs of Deficiency?)

Magnesium deficiency, also referred to as hypomagnesia, may present serious problems to your health. Luckily, such a deficiency may be relatively easily remedied through an increase of magnesium in diet, oral supplements, and in severe cases, intravenous supplementation. Magnesium deficiency may present itself in any number of ways; here are a few signs and symptoms to look out for:

• Agitation, irritability, anxiety
• Confusion
• Nauseas and vomiting
• Muscle spasm and weakness
• Nausea and vomiting
• Hyperventilation
• Abnormal heart rhythms
• Low blood pressure
• Insomnia and other sleep disorders, including restless leg syndrome
• Seizure

Talk to your doctor if you think you may be experiencing a deficiency in magnesium. A standard serum magnesium test can help diagnose severe hypomagnesemia. Long-term inadequate intake of magnesium may be dangerous to your health and can increase the risk of medical complications and illnesses, such as high blood pressure, heart disease, diabetes, osteoporosis, and migraine.

While magnesium deficiency is often effectively treated with an oral supplement, your doctor may recommend treatment through an alternate method of administration such as dermal absorption using Epsom salts, enema, nebulizer therapy, as well as intravenous or intramuscular injection.

What Foods have Magnesium? How do you get enough from foods?

Leafy green vegetables, soybeans, raw nuts, and fruit are the best food sources of magnesium. As with all minerals in foods, magnesium must be present in the soil where the food is grown. The best food sources of magnesium include:

• Beans, especially soybeans
• Whole grains, including bran
• Nuts like almonds and brazil nuts
• Seeds, including flaxseed, sesame, and sunflower
• Leafy greens
• Dry cocoa powder—and even dark chocolate

While a diet rich in these foods will help regulate your intake of magnesium, supplementation may prove necessary. Refer to the “What Happens If You Don’t Get Enough Magnesium (Signs of Deficiency?)” section of this page for information on magnesium supplementation.

Possible Side Effects of too much Magnesium

It is important to note that getting too much magnesium—also referred to as hypermagnesemia–may possibly be unsafe. Doses less than 350 mg daily are safe for most adults. Large doses might cause too much magnesium to build up in the body, leading to serious side effects such as irregular heartbeat, low blood pressure, confusion, slowed breathing, coma, and even death.

For more information on the dosage of magnesium that is correct for you, refer to the “How Much Magnesium Do I Need?” section of this page.

 Other names for Magnesium

Epsom salts—or magnesium sulfate—can be found at your local drugstore. Epsom salt baths have been used for many generations to treat various health-related issues. Essentially, Epsom salts break down into magnesium and sulfate when placed in water. An Epsom salt bath, therefore, is thought to provide your body with magnesium supplementation through your skin. To that end, people use Epsom salt baths as a home treatment for:

• Arthritis pain and swelling
• Sore muscles after working out
• Insomnia
• Tired, swollen feet
• Bruises and sprains
• Fibromyalgia—a condition that causes pain throughout the body, including muscles, ligaments, and tendons
• Ingrown toenails
• Psoriasis—a disease that causes red, itchy, scaly skin
• Soreness from diarrhea during chemotherapy
• Sunburn pain and redness

It is important to note that Epsom salt baths—while largely believed to provide therapeutic relief—have not been clinically proven to treat or heal any medical condition. And while taking an Epsom salt bath probably won’t hurt you, but if you have questions, be sure to check with your doctor before you jump in the tub.

Special Considerations for Magnesium

While magnesium has proven essential to key systems in the body, including protein synthesis, muscle and nerve function, and blood pressure regulation, its benefits in other area of medicines remains to be explored. Perhaps the segment of medicine that may reap the most benefit from magnesium is in the prevention of diabetes. Researchers have proven a direct correlation between magnesium and blood glucose levels. Accordingly, these data have shown the following:

• Magnesium levels are inadequate in people with diabetes
• People with higher magnesium levels do not develop diabetes
• Magnesium supplementation appears to help reverse pre-diabetes

It is interesting to note that the overall health benefits of magnesium may not have yet been fully realized. Be sure to talk to your doctor about your magnesium intake during your annual check-up.

Vitamin D is one of the most versatile vitamins for improving your overall health. There are two forms of vitamin D: Vitamin D2, which is commonly found in foods, and Vitamin D3, which your body naturally creates through direct exposure to sunlight. Vitamin D3 is the only vitamin that your body creates on its own. Technically, D3 doesn’t even officially count as a vitamin since the definition of vitamin is that of an organic chemical that must be obtained from dietary sources. Vitamin D is actually produced in the human body as a result of exposure to sunlight. While egg yolks and fish contain some vitamin D, the body must first transform it before it can be of any use.

Vitamin D3 has been shown to improve overall health and is commonly used to treat conditions such as:

• Osteoporosis
• Underactive parathyroid glands
• Diminished blood phosphate levels
• Maintenance of pH levels in the blood

Natural absorption of vitamin D3 requires your skin to be in direct contact with sunlight. The widespread use of sunscreens, medical recommendations for limiting sun exposure, and increase in sun-related skin cancers, vitamin D3 deficiency is more prevalent than ever. As well, the darker your skin, the longer you need to be exposed to sunlight for your body to synthesize vitamin D3. Darker skin contains more melanin, which equates to greater protection against ultraviolet radiation exposure. Because of this protective effect, people of color must spend more time in the sun to make vitamin D compared to those with lighter skin tones.

Why is Vitamin D3 important/necessary? 

While vitamin D3 plays a key role in bone health, and can help treat or regulate osteoporosis, under-active parathyroid glands, and blood phosphate and pH levels, its effects on your body may be more extensive.

Historically, vitamin D3 deficiency has been associated with rickets—a disease that primarily begins during childhood as a result of low levels of D3. Rickets is known to cause bow-shaped legs in the children—and even adults—it affects. Experts continue to study the effects of vitamin D3 on bone formation and health; stay tuned for more information on this topic as research continues.

Aside from bone health, vitamin D3 is key for people suffering gastrointestinal (GI) problems such as celiac, liver, or Crohn’s disease. Because these debilitating conditions often keep these patients indoors, they are more likely to suffer vitamin D3 deficiency. And although a lack of vitamin D3 has not been proven to cause these GI disorders, the key effects of D3 in everyday function continues to be explored.

What Vitamin D3 does for your Body?

As noted previously, vitamin D3 plays a key role in bone health. Ongoing research shows that D3 may significantly your reduce risk for bone fractures. Furthermore, vitamin D3 can protect your body from conditions such as:

• Depression
• Back pain
• Cancer
• Insulin resistance
• Preeclampsia (in pregnant females)
• Impaired immunity
• Macular degeneration

Research shows that vitamin D3 plays a significant role in your overall health; at the same time, however, D3 deficiency is emerging as a key concern in patient care. So, the key question remains: how do you balance adequate exposure to sunlight—and D3 absorption—with the risks of sun-related skin cancers while also caring for your overall health?

How Much Vitamin D3 Do I Need?
Because it is difficult to determine the amount of vitamin D3 that you obtain from sunlight each day, oral supplementation is recommended. Vitamin D3 may be purchased over-the-counter at dosages of 400 and 1,000 international units (IU).

For starters, you should not consume more than 4,000 IU of vitamin D3 per day unless recommended by your doctor.

If you are 50 years or older and have been diagnosed with osteoporosis, you should take 800 to 1,000 IU of vitamin D3 each day. You may also require a calcium supplement.

If you are diagnosed with an underactive parathyroid, your doctor will determine the D3 dose that’s best for you.

For treating vitamin D-resistant rickets in children, your pediatrician may prescribe a much higher dose of D3, ranging from 12,000 to 500,000 IU per day.

Finally, when it comes to taking the supplement, most agree that vitamin D3 goes down best with food. Bon Appétit!

What Happens If You Don’t Get Enough Vitamin D3 (Signs of Deficiency?)

A lack of vitamin D3 may be a key factor to promoting proper bone health. In fact, data show that D3 significantly reduces your risk for bone fracture.

So, why is vitamin D3 so important?

While D3 is primarily absorbed via direct exposure to sunlight, we must work together to determine the “balance” of adequate “tanning” with the inherent risks of sun-related skin cancers. And at the same time, we need to care for our overall health to ensure that our intake of D3 is sufficient enough to inhibit:

• Depression
• Back pain
• Cancer
• Insulin resistance
• Preeclampsia (in pregnant females)
• Impaired immunity
• Macular degeneration

What Foods have Vitamin D3? How do you get enough from foods?

Vitamin D—like other nutrients—is key to your overall health. With fat-soluble properties, your vitamin D3 intake plays an important role in your cardiovascular, bone, and mental health. So, how can you be sure that your diet includes enough D3?

• To start, fish provides the best food source of vitamin D—especially catfish, salmon, trout, and halibut

• Fortified soy products also provide a significant proportion of your ideal daily D3 intake

• Fortified milk and juice, such as orange juice fortified with calcium and vitamin D, and cow’s milk, offer a good source of D3

• Mushrooms are the only vegetable that act as a naturally occurring source of vitamin D

Possible Side Effects of too much Vitamin D3

An increasing cohort of vitamin D3 experts—all of whom have vast expertise in the study of this important nutrient—are noted with studying vitamin D3’s high safety profile in doses up to 10,000 IU per day. Of note, they have determined that D3 plays a wide role in our health. The group of experts contends that consuming 2,000 to 4,000 IU per day may prove that D3 is a way to improve overall health.

Other names for Vitamin D3

Vitamin D3 is commonly referred to as cholecalciferol. It is also marketed under the brand names:

• Calciferol
• Drisdol

Special Considerations for Vitamin D3

While vitamin D3 is proven to treat a variety of conditions, its potential for additional applications remains unknown. For instance, researchers have begun to examine the effects of vitamin D3 in the treatment of treat acne. Although clinical trials have not yet been conducted to study the effect of D3 on acne, subjective evidence suggest that vitamin D3 may improve the appearance of acne.

Other studies suggest that people who are overweight may have higher levels of vitamin D3. This may be attributed to the fact that vitamin D3 is an oily element often stored in the body’s fat tissues. These studies, therefore, suggest that the amount of body fat that you have may be directly correlated to how easily your body can store vitamin D3.

Stay tuned for additional applications of vitamin D3.

Drum roll, please … that’s where vitamins and minerals come into play.  Critical for growth and development since we were born, these essential nutrients now assume an entirely new role as we get older.

Vitamins come in two types. Water-soluble vitamins travel freely through the body, while fat-soluble vitamins are stored in the body’s cells. Minerals can also be classified into two categories: major minerals, which are required in high quantities, and trace minerals, which – as the name implies – are needed in much lesser amounts.

Here are the top vitamins and minerals essential for women over 40 – and why.

Vitamin D + Calcium + Vitamin K2

Critical for strong bones and teeth, vitamin D is also necessary for calcium absorption. Calcium, also highly reputed for its bone-strengthening properties, helps support heart, muscle and nerve function as well.  When taken in concert, the two may potentially give you the support you need to stave off high blood pressure, cancer and diabetes. Layer in vitamin K2, produced in the gastrointestinal tract, and you have the foundation of a smooth-running digestive system plus help ensure the calcium gets where it’s needed.

Magnesium

Often an unsung hero, magnesium is a major mineral responsible for everything from muscle relaxation, nutrient metabolism and cholesterol production to cell membrane structure, energy production and heart health. Of particular value to women over 40, magnesium also supports strong bones and teeth by regulating the body’s use of calcium, and may give you support to help prevent certain aging-related chronic diseases.

Vitamin C

Popularly used to combat the common cold, vitamin C is a powerful antioxidant that is also critical for tissue growth and repair. Not only that, but it can be credited for giving you support for protection against high blood pressure, cancer, cardiovascular disease, immune system deficiencies, eye disease and skin wrinkling – all of which concern us as we approach the half-century mark.

Iodine + Selenium

These two trace minerals are another pair that operates best in tandem.  Iodine is a necessary nutrient for thyroid health, and selenium helps the body recycle iodine. When ingested in appropriate levels, they complement each other and are a formidable, synergistic force.  If a deficiency exists in one or either, however, there’s a strong likelihood of thyroid imbalance.

Vitamin B Complex

A nutritional powerhouse, vitamin B complex’ main task is to convert food into the energy our bodies need. Each of its eight individual vitamins – B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folate) and B12 (cobalamin) – has equally unique and important responsibilities.  They include support to promoting healthy skin and hair, preventing memory loss, protecting the immune system, boosting good cholesterol, reducing stress and preventing early aging – all of which have great appeal to women over 40.

As a holistic practitioner, I am a firm believer that good foods equate to good health. While the above information has served me well in my practice for decades, I recommend discussing it with your physician to make sure it’s appropriate for your nutritional needs.

Sergey Kalitenko MD is a holistic practitioner, Board Certified in Internal Medicine.  He has two practices located in Great Neck, Long Island and Brooklyn.  Dr. Kalitenko opened his private practice in 2001.  His medical practice is based on the principles of holistic, functional medicine as well as age management principles. Bioidentical hormone replacement therapy is a keystone of his practice.  He is firmly committed to finding natural solutions to health problems—and his first step is to use his expert diagnostic skills to get to the root of the problem. Dr. Kalitenko’s philosophy is that of wellness, not illness. For more information go to www.kalitenko.com.

What is Zinc?

Zinc is an essential trace mineral that is intricately involved in hundreds of activities inside our cells. At the moment, research estimates that 100 to 300 different enzymes require zinc to accomplish their tasks. In many cases, zinc acts as a catalytic component for those enzymes, aiding the biochemical processes that help cells function regularly. Enzymes, and even hormones, hormone receptors, and other proteins, also need zinc as a building block in their own chemical structures.

Zinc helps enzymes and other molecules carry out cellular processes like DNA synthesis, cell division, gene expression, cell death, and cell metabolism, making it vital to our normal growth and development and overall health. Not only does zinc help grow our bodies; it also helps protect it by supporting our immune cells, augmenting antioxidant activity, and facilitating healing of open wounds. In recent years, research has also found possible associations between zinc and normal learning and emotional functioning in our brains.

What are Signs of Zinc Deficiency?

Zinc’s specific roles in healthy bodies explain many of the symptoms that arise when zinc is deficient.

Stunted Development

A major result of zinc deficiency is slowed growth. Some signs are a loss of appetite and/or weight loss. Without zinc to support DNA synthesis and cell division, there is, in some sense, a lacking ability to sustain the cellular processes that ultimately lead to a growing body. Zinc deficiency is even felt in the brain, altering central nervous system development and less-tangible traits like behavior. Overall mental slowness can result. Also related to development – a severe absence of zinc for normal sex hormone production can lead to delayed sexual maturity in both males and females, seen as delayed menstruation in females and a lack of reproductive organ development and low sperm count in males.

Impaired Immune Function

In research on children from developing countries, a strong association is found between low zinc status and increased susceptibility to pneumonia and infections that cause diarrhea. One theory for this link is that, like most cells, immune cells need zinc to undergo cell division and propagate. Zinc deficiency may result in a smaller pool of first-line-of-defense immune cells that can attack infectious viruses and bacteria. Secondly, research has found zinc deficiency decreases the activity of macrophages, a specific subset of immune cells that activates other immune cells and can engulf and dispose of cellular waste, bacteria, or like in the picture below, even cancer cells.

Delayed Wound Healing

Zinc is involved in numerous processes that enhance skin cell migration and the removal of old skin cells during wound repair. It also has some antioxidant activity when combined with the enzyme, superoxide dismutase (SOD), which can help fight against bacterial toxins and prevent tissue damage from inflammation. In individuals with low zinc levels, wounds take longer to heal and the risk for tissue cell death is increased.

 Effects on Prostate, Eyes, Taste, and Smell

Some researchers caution that zinc deficiency can initiate prostate enlargement or even prostate cancer because zinc is unavailable for normal DNA synthesis and cell division. In eyes, zinc plays a very important role in delivering vitamin A from the liver to the retina so that melanin, a protective pigment, can be produced. Without adequate zinc, the risk for poor night vision and cataracts can increase. Even an enzyme involved in our ability to taste and smell relies on zinc to be active. A loss of smell is a common first sign of chronic zinc deficiency.

High-Risk Groups

With all the research surrounding zinc deficiencies, studies have also shown that symptoms can be corrected in part by zinc supplementation. Some reasons for zinc deficiencies in the US are not so obvious, and even though you might consider your diet to be well-balanced, you could still be at risk for consuming too little zinc. Here are some groups who are at higher risk:

• Vegetarians

Even though zinc is present in non-meat sources like beans, grains, and seeds, zinc concentrations are comparatively lower than in meats. In addition, phytates – present in whole-grain breads, cereals, and legumes – bind zinc and inhibit its intestinal absorption. Soaking beans, grains, and seeds in water for several hours before cooking may make their zinc more available. Research also shows that leavening seems to break down phytates, so leavened grain products like bread may be a better zinc source than unleavened products like crackers.

• Older Adults

As we age, our diets tend to become less diverse, which limits a portion of the nutrients we take in. Meat, with its more bioavailable zinc, is frequently left out of meals. A national health study found that 35-45% of adults aged 60 years or older do not consume enough zinc in their diets. 25% of the subjects were still zinc deficient even after zinc supplements were taken into account.

• Pregnant Women

Because fetuses require high levels of zinc for rapid growth and development, pregnant women may be more susceptible to zinc deficiency. Also, prenatal vitamins tend to include iron and folate in their formulations, which can significantly decrease the bioavailability of zinc. Zinc deficiency in pregnant women increases the risks for maternal morbidity, preterm delivery, and babies who are smaller than normal for their gestational age.

• Exclusively Breastfed Infants

Breastfeeding tends to decrease zinc stores for mothers, but also, the zinc levels in breast milk are not high enough for infants past a certain age. Breast milk provides about 2 mg of zinc per day, enough for babies only in the first 4-6 months of life. Once the baby reaches 7-12 months, they will require 3 mg of zinc per day, at which time, age-appropriate foods and/or formulas are recommended.

How Much Zinc Do You Need?

Human zinc stores need to be partially replenished daily. These are Institute of Medicine’s established Recommended Dietary Allowances (RDAs) per day for the average healthy individual:

• 0-6 months: 2 mg
• 7-12 months & 1-3 years: 3 mg
• 4-8 years: 5 mg
• 9-13 years: 8 mg
• 14-18 years: 11 mg (males), 9 mg (females), 12 mg (pregnancy), 13 mg (lactation)
• 19+ years: 11 mg (males), 8 mg (females), 11 mg (pregnancy), 12 mg (lactation)

Zinc Food Sources

According to USDA National Nutrient Database listing zinc content for specific foods, oysters contain more zinc per serving than any other food. However, red meat and poultry are also great sources and provide the majority of zinc in the American diet. If you’re looking for non-meat foods that are high in zinc, beans, nuts, seeds, whole grains and oats, and fortified cereals are some good options. As mentioned previously, though, these sources have slightly limited zinc bioavailability compared to meats. For some unconventional natural sources of zinc, you can also try crab, wild rice, and soybeans. The USDA’s comprehensive list of zinc food sources is available here.

Review Top Zinc Supplements on LabDoor.com

LabDoor tested 30 best-selling zinc supplements in the US using 210 analytical chemistry assays to measure active and inactive ingredients and determine whether products had harmful levels of heavy metals. Products were relatively accurate in their label claims. Measured zinc levels deviated an average of 4.4% from their respective label claims. 26 products measured at least 11 mg of zinc per serving, meeting the Recommended Dietary Allowances (RDAs) per day for adult males and nonpregnant females. Twenty of 30 products measured more than 20 mg of zinc per serving even though research on absorption rates of zinc has found that further increasing zinc doses above 20 mg produces diminishing returns on absorption.

LabDoor is an online review service that helps consumers research, find, and buy the best supplements. Behind the scenes, each product is sent to an FDA-registered laboratory, where scientists perform key purity and label accuracy assays. Consumers can get simple grades and rankings based on these lab results on LabDoor’s web, iOS, and Android applications.

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