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    VITAMINS AND MINERALS.

    Health Benefits, Deficiency, and Toxicity of Vitamin Dietary Supplement Product

    Vitamin Health Benefit Deficiency Toxicity
    Fat-Soluble Vitamins
    Vitamin A (beta-carotene or retinol) Maintenance of normal vision and night vision

    Essential for immune system

    Necessary for growth; induces differentiation of cells
    Fairly common; results in night blindness and eye disease, dry pimply skin, increased infections, and kidney stones Unlikely from diet alone, but supplements and excessive fish oil may produce toxic symptoms such as increased skull pressure, hair loss, and blurred vision
    Vitamin D (calciferols) Helps to maintain constant levels of calcium in the blood

    Important in insulin and prolactin secretion, muscle function, immune and stress response, melanin synthesis, and cellular differentiation

    Vital for kidney and parathyroid gland function

    Necessary for healthy bones
    Disease is rickets, not a major problem in U.S.; symptoms include soft bones and teeth Most people do not take in supplemental form since the body produces its own via exposure to the sun

    Toxic in doses larger than 1,000-1,1500 I.U.s daily for a month or longer; produces nausea, weakness, and irritability

    May lead to brain or liver damage, jaundice, and the destruction of red blood cells
    Vitamin E (tocopherols) Protects vitamin A from oxidation during digestion

    Enhances immune response

    Inhibits carcinogens from reaching target sites

    Can stop neurological problems associated with cystic fibrosis, liver disease early in disease process

    Detoxifies free radicals, prevents damage to cell membranes

    Prevents LDL cholesterol from turning into damaging oxidized LDL, which initiates buildup of arterial plaque which can lead to heart disease
    No disease; may produce vague symptoms and anemia Unlikely, although high doses increase the action of anticoagulant medications

    High doses also

    interfere with the absorption of other fat-soluble vitamins, particularly vitamin K
    Vitamin K (phylloquinone) Helps blood coagulate

    In conjunction with vitamins A and D helps body build bone protein

    Given as injection to newborns to help blood clot, sometimes to women before labor or to patients before and after surgery
    Rare From food it is rare; can occur with medical treatment

    Not sold as a supplement



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    Vitamin Health Benefit Deficiency Toxicity
    Water-Soluble Vitamins
    Vitamin B-1 (thiamin) Vital for healthy nervous system and nerve transmission

    Essential in converting glucose to energy
    Disease is beriberi

    Symptoms of a deficiency include depression, irritability, attention deficit

    Severe deficiency leads to edema,
    paralysis, and heart failure
    No toxicity has been reported by those taking large doses over prolonged periods of time
    Vitamin B-2 (riboflavin) Essential for metabolizing carbohydrates, fats, and lipids and for the degradation of fatty acids and the synthesis of ATP

    Acts as an intermediary in the transfer of electrons in oxidation-reduction reactions

    Necessary for the function of vitamins B-6, folic acid, and niacin

    Involved in formation of red blood cells and maintenance of body tissues, particularly the skin and eyes
    Symptoms are dry, scaly skin on face, oral swelling, and cracking at the corners of the mouth No evidence that high doses have toxic effects
    Vitamin B-6 (pyridoxine) Necessary for immune system function, hormone modulation, gluconeogenesis

    Essential in making certain amino acids and turning others into hormones

    Involved in metabolizing polyunsaturated fats and proteins

    Used to build red blood cells and maintain nerve tissue

    Formation of niacin
    Not common; symptoms include mouth sores, nausea, nervousness, anemia, convulsions High doses over prolonged periods are very toxic and can cause temporary or permanent nerve damage
    Vitamin B-12 (cobalamin) Works with folic acid to
    produce red blood cells

    Helps build and maintain protective nerve sheaths

    Needed for RNA and DNA synthesis
    Pernicious anemia, muscle and nerve paralysis None reported



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    Vitamin Health Benefit Deficiency Toxicity
    Water-Soluble Vitamins (continued)
    Vitamin C (ascorbic acid Activates liver-detoxifying systems

    Antioxidant to inactivate highly reactive oxygen species; protects against damage to lipids and other molecules

    Inhibits formation of carcinogenic compounds

    Protects cellular functions

    Enhances function of key white blood cells involved in the destruction of bacteria

    Protects vitamin E

    Integral to maintenance and building of collagen, a protein that holds the body's cells in place

    Vital to bones and teeth, blood vessels, healing of wounds, and iron absorption

    Helps metabolize several amino acids and hormones
    Scurvy is the deficiency disease Mostly nontoxic; diarrhea is a side-effect

    High doses not recommended for those with genetic conditions that cause iron overload
    Biotin Key role in metabolizing fats, carbohydrates, and proteins

    Part of a number of enzymes in which it functions as a carboxyl carrier

    Manufactured in lower digestive tract by bacteria
    Not common; symptoms include baldness, a rash around the mouth and nose, and dry, flaky skin No evidence of toxicity at high doses
    Choline Helps maintain central nervous system

    Precursor to acetylcholine, a neurotransmitter

    Involved in production and metabolism of fats and cholesterol

    Protects liver from fatty deposits
    Increased fatty deposits in liver, memory loss, poor muscle coordination Nontoxic, but excess consumption may result in tension headache
    Folic acid (folate, B vitamin Used by body to break down and synthesize amino acids

    Helps synthesize nucleic acids, which are needed to build new cells, particularly red blood cells

    Involved in a variety of reactions in amino acid and nucleotide metabolism

    Recommended for women of childbearing age; helps prevent neural tube birth defects
    Leads to anemia similar to that caused by B-12 deficiency

    Can exist without anemia with broad signs including generalized weakness, easy fatigability, irritability, and cramps
    Can mask B-12 deficiency (which causes neurologic problems) at high doses and interfere with some seizure and cancer drugs
    Niacin (sometimes called vitamin B-3) Enables body to use

    carbohydrates, fats, and proteins (to provide energy), and amino acids

    Influences metabolism of DNA, NAD, NADP

    Aids nervous system and digestive tract function and promotes healthy skin
    Disease is pellagra, rare in U.S.

    Symptoms of deficiency: digestive upsets, insomnia, headaches, fatigue, sore and swollen tongue (disease is much worse)
    Symptoms may include itching, skin flushing, and gastrointestinal distress

    Time-released capsules have caused impaired liver function, reported jaundice, and liver failure

    Toxic in high doses

    May produce skin discoloration and dryness, decrease glucose tolerance, produce high uric acid levels, aggravation of peptic ulcers, and symptoms that accompany hepatitis
    Pantothenic Acid Necessary for adrenal cortex function

    Part of chemistry of coenzyme A, which is vital to metabolism of carbohydrates, fats, and proteins and involved in making fatty acids, cholesterol, acetylcholine, steroid hormones, and nerve regulators
    Can result in abdominal distress, vomiting, cramps, burning in heels, fatigue, and insomnia No known toxicity, but research has been inadequate



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    Health Benefits, Claims, Deficiency, and Toxicity of Leading Mineral Dietary Supplement Products
    These claims have not been evaluated by the Food and Drug Administration. DS products may not include statements that they diagnose, treat, cure, or prevent disease.


    Mineral Health Benefit Claims Suppor
    for Claims
    Deficiency Toxicity
    Calcium-(a) Developing and maintaining healthy bones and teeth

    Assists in blood clotting, muscle contraction, nerve transmission

    Involved in production of energy and maintenance of immune function
    Reduces the
    risk of osteoporosis

    Prevents
    cancer

    Useful in
    treating high blood pressure; lowers cholesterol; helps prevent cardiovascular disease

    Helps alleviate cramps in the legs

    Useful in treating and preventing arthritis

    Helps keep skin healthy
    Effect against osteoporosis proven

    Studies suggest may help prevent cancer

    Studies say it helps reduce high blood pressure and CVD; mixed results for lowering cholesterol

    Anecdotal evidence it is used for leg cramps and as a tranquilizer

    No evidence for treating arthritis or healthy skin
    If severe, may lead to abnormal heartbeat, dementia, muscle spasms, and convulsions

    Brittle, thinning bones (osteoporosis)
    High doses
    may cause constipation
    and interfere
    with kidney
    function and
    iron absorption

    Causes tissue calcification

    May cause magnesium deficiency
    Chromium Aids in glucose metabolism and regulates blood sugar; essential trace element Treatment and prevention of diabetes

    Protects against cardiovascular disease and high blood pressure

    Useful in treating hypoglycemia
    No evidence that it prevents diabetes, although there is evidence that it may increase glucose tolerance

    Contradictory evidence for protecting against CVD and high blood pressure

    Aid re: hypoglycemia unclear
    Possibly
    glucose intolerance, impaired
    growth, elevated blood cholesterol,
    and fatty deposits in the arteries
    Hexavalent
    chromium is
    toxic and carcinogenic,
    but the dietary
    form (trivalent)
    has very low
    toxicity

    Trivalent form
    not associated
    with any type
    of cancer
    Copper Essential trace element; one of the factors in hemoglobin formulation; helps stimulate the absorption of iron; plays a role in respiration

    Helps maintain cell membranes; part of enzyme that protects against cellular damage; prevents peroxidation of polyunsaturated fatty acids

    Involved in production of collagen, elastin, melanin, and the neurotransmitter noradrenalin
    Anticancer substance

    Protective against cardiovascular disease

    Anti-inflammatory and useful against some forms of arthritis

    Immune booster
    No evidence for anticancer claims

    Studies done, need more re: protection against CVD

    Promising studies as an anti-inflammatory agent; need more work

    Role in human immune system needs clarification
    Second most common
    trace metal
    deficiency occurring
    during intravenous feeding

    Symptoms include anemia that is unresponsive
    to iron, lowered white blood
    cell count, and loss of bone density (osteoporosis)
    Relatively
    nontoxic
    Iodine Integral part of the thyroid hormones that have important metabolic roles; factor in the thyroid gland's regulation of energy production Protects against toxic effects from radioactive materials

    Relieves pain and soreness from fibrocystic breasts

    Good for loosening up clogged mucus in the breathing tubes

    Good antiseptic

    Does protect from toxic effects of radioactive materials

    More research needed for fibrocystic breast relief

    Iodine containing drugs (need prescription) are useful for loosening coughs

    Effective in purifying back-country water (not elemental)
    Major cause
    of hypothyroidism in the world

    Symptoms include chronic fatigue,
    apathy, dry
    skin, intolerance to cold, weight gain, and enlargement of the thyroid
    High doses
    may aggravate
    acne (rare from
    diet or typical supplement consumption)

    High doses
    may lead to a
    temporary block
    of hormone
    synthesis and temporary hyperthyroidism

    Over prolonged periods, high
    doses may
    result in hyperthyroidism

    High doses
    greater than 50 milligrams/day
    may lead to inflammation of
    the salivary
    glands, which is easily reversed
    Iron Necessary in red blood cell formation and function

    Protection from oxidant damage; maintenance of the immune system

    Backbone of energy-producing process

    Involved in the production of carnitine, collagen, elastin, several brain neurotransmitters
    Prevents and cures iron-deficiency anemia

    Anticarcinogenic

    Boosts physical performance

    Prevents learning disorders in children
    Prevents iron-deficiency anemia

    Anticancer evidence is meager; appears to play an important role in cellular immunity

    More research needed for muscular performance claim

    Evidence says may help prevent learning disorders in kids
    Iron-deficiency anemia (significant decrease in number of red blood cells), which means decreased oxygenation of tissues and symptoms of fatigue and muscle weakness (Note: iron is the treatment for this deficiency)

    Associated with Plummer-Vision Syndrome, when there is difficulty in swallowing solid food because a web-like membrane grows across the esophagus (Note: supplementation has been found to eliminate this condition)
    Toxic after
    prolonged usage; reports are rare

    Some concern
    that unbound
    iron can generate free radicals
    and be
    destructive to
    cells, but usually occurs just with certain genetic disorders

    Over
    supplementation
    may cause
    abdominal pain, diarrhea, or constipation



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    Mineral Health Benefit Claims Support for Claims Deficiency Toxicity
    Magnesium Activates nearly 100 enzymes; helps nerves and muscles function;

    necessary for every major biological process (e.g., glucose metabolism, production of cellular energy, and the synthesis of protein and nucleic acids)

    Regulator of calcium flow within cells; collaborates with calcium in the production of biologic energy
    Protects against cardiovascular disease and helps in treatment of high
    blood pressure

    Helps in treating PMS

    Helps prevent kidney and gallstones

    Treats prostate problems

    Useful in treating polio, postpolio syndrome

    Helps fight depression

    Helps in treating neuromuscular and nervous disorders

    Good for treating convulsions in pregnant women to prevent premature labor

    Helps with diarrhea, vomiting, and indigestion
    Conflicting findings about role in CVD, but have found that magnesium plays an important role in the maintenance of the electrical and physical integrity of the heart muscle

    Insufficient research in helping PMS

    No evidence that is helpful in treating gallstones, but evidence exists that it is helpful in preventing calcium oxalate kidney stones in people who have this recurrent problem

    No evidence to support this

    No evidence to support this

    No evidence to support this

    Intravenous magnesium used to treat this

    No evidence of benefit for those with these symptoms unless symptoms are due to magnesium deficiency

    Early symptoms of deficiency; products on market containing magnesium actually cause diarrhea, and it is used in laxatives
    Loss of appetite, nausea, vomiting, diarrhea, confusion, tremors, loss of coordination, and occasionally fatal convulsions

    Sometimes associated with calcium and potassium deficiencies at the same time

    Marginal deficiency is common
    People with impaired kidney function can accumulate magnesium, which can be fatal

    Those with high-grade atrioventricular blocks or bifascicular blocks should not take (could slow heart rate)

    No evidence it is harmful other than in these two instances
    Manganese Essential part of several enzyme systems, involved in protein and energy metabolism Antioxidant

    Important for normal function of the brain, effective in treating schizophrenia and other nervous disorders

    Necessary for reproduction

    Needed for normal bone structure and helpful in treating osteoarthritis

    Necessary for normal glucose metabolism and beneficial in treating diabetes mellitus
    Not clear; needs more research

    Appears to be involved in synthesis of neurotransmitters in brain, anecdotal reports that it works on schizophrenia, but no scientific reports

    Not demonstrated in humans

    Need more research

    No evidence in humans nor for treating diabetes
    Not documented in humans; only one report of man who was on a manganese-deficient diet for 4 months Dietary form has low toxicity, inhaled dust can cause serious neurologic disease
    Molybdenum Necessary for several enzymes May be an antioxidant, protect against cancer

    May be a detoxifier of potentially hazardous substances (sulfiting agents for preserving drugs and food)

    Protects teeth

    Prevents sexual impotence

    Prevents anemia and mobilizes iron
    No evidence supplementation protects against cancer

    No evidence supplementation protects against cancer

    No clinical support

    No evidence

    Role not thought to be significant
    Only one report of deficiency, from a patient fed intravenously Noted in animals due to antagonism of copper
    Phosphorous Works with calcium to develop and maintain strong bones and teeth; enhances use of other nutrients

    Component of cell membranes

    Important in vital biologic processes (storage and processing of biological information, cellular communication, energy production, and integrity of tissue)
    Increases endurance in athletes

    Fights fatigue, overall good tonic
    If adequate phosphate intake, supplementation will not boost energy only if suffering from depletion (if alcoholic, antacid user, various medical conditions)

    Homeopathic remedies claim this, no adequate research on its effectiveness
    Rare, although severe deficiency could lead to seizures, coma, and death

    Depletion has been reported in those taking antacids between 2 and 12 years because antacids contain magnesium and aluminum, both of which prevent the absorption of phosphate into the body
    Toxic; treatment of deficiency should be administered by physician



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