Vitamins & Minerals

What are vitamins?
Vitamins are natural substances found in plants and animals. Your body uses these substances to stay healthy and support its many functions. There are two types of vitamins: water-soluble and fat-soluble.

What are water-soluble vitamins?
Water-soluble vitamins are easily absorbed by your body. Unlike fat-soluble vitamins, they don't have to be absorbed using bile acids (fluids used to digest fats). Your body doesn't store large amounts of water-soluble vitamins. The water-soluble vitamins you don't need are removed by your kidneys and come out in your urine.

What are fat-soluble vitamins?
Your body has to use bile acids to absorb fat-soluble vitamins. Once these vitamins are absorbed, your body stores them in body fat. When you need them, your body takes them out of storage to be used. Eating fats or oils that are not digested can cause shortages of fat-soluble vitamins. This includes using mineral oil frequently to treat constipation or eating the fat substitute Olestra.

What are minerals?
Minerals come from the earth or from water. Plants and animals absorb them to get nutrients. Download the PDF file below for a few details about the major minerals.

Do I need to take vitamin and mineral pills?
The best way to get the vitamins and minerals your body needs is from the food you eat. Most people don't need to take additional vitamin and mineral supplements. You should never take extra vitamins and minerals without talking to your doctor first. However, your doctor may suggest taking extra vitamins or minerals if you have certain health problems. You also may need more vitamins and minerals at certain times in your life, such as the following:

• If you are a woman and are trying to get pregnant, your doctor will likely suggest you take a pill that contains folic acid. Women who don't get enough folic acid during pregnancy are more likely to have a baby with neural tube defects (serious problems of the brain or spinal cord). It's important to take folic acid before becoming pregnant because these problems develop very early in pregnancy.
• If you're pregnant or breastfeeding, your doctor may suggest that you take a prenatal mineral and vitamin pill that includes iron to protect you against anemia, calcium to keep your bones strong and folic acid.
• If you're a woman and are at risk of osteoporosis, your doctor may suggest that you take a calcium supplement to support the health of your bones.
• If you eat a vegetarian or vegan diet (a diet that limits the animal products you eat), your doctor may suggest that you take a vitamin B12 supplement.
  

Can vitamin and mineral pills be dangerous?
Vitamins and minerals aren't dangerous unless you get too much of them. It would be hard to "overdose" on vitamins or minerals that you get from the foods you eat. But if you take supplements, you can easily take too much. This is even more of a risk if you take fat-soluble vitamins.
Sometimes, taking too much of a vitamin or mineral can lead to problems such as the side effects listed in the boxes above. Taking too much can also cause problems with some medical tests or get in the way of how some drugs work. It's very important to talk with your doctor before you take any vitamin and mineral pills, especially if you take prescription medicines, have any health problems or are elderly.
(AAFP)
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Herbal Products & Supplements

Are herbal health products and supplements safe because they're natural?
Not necessarily. Don't think that herbal health products and supplements are safer than medicines just because they occur in nature or come from plants.
After all, many plants are poisonous! Although herbal products and supplements are advertised as "natural," they aren't necessarily natural to the human body.
Unlike prescription and over-the-counter (OTC) medicines, herbal products and supplements don't have to be tested to prove they work well and are safe before they're sold. Also, they may not be pure. They might contain other ingredients, such as plant pollen, that could make you sick. Sometimes they contain drugs that aren't listed on the label, such as steroids or estrogens. Some of these products may even contain toxic (poisonous) substances, such as arsenic, mercury, lead and pesticides.

What types of herbal products and supplements are available?
Hundreds of herbal products and supplements are available. They are advertised to treat just about any symptom. However, trustworthy evidence usually doesn't exist to support these advertising claims.
Some of the most popular herbal products and supplements include chondroitin sulfate, echinacea, ephedra (also called ma huang), garlic, ginkgo biloba, ginseng, glucosamine, kava, melatonin, phytoestrogens (such as black cohosh, dong quai and soy), saw palmetto and St. John's wort.

Do any health problems increase the danger of taking herbal products and supplements?
Yes. Herbal products and supplements may not be safe if you have certain health problems. You also may be at increased risk of problems from these products if you are elderly. Talk to your doctor before taking herbal products if you have any of the following health problems:

• Blood clotting problems
• Cancer
• Diabetes
• An enlarged prostate gland
• Epilepsy
• Glaucoma
• Heart disease
• High blood pressure
• Immune system problems
• Psychiatric problems
• Parkinson's disease
• Liver problems
• Stroke
• Thyroid problems
  

If you are going to have surgery, be sure to tell your doctor if you use herbal products. Herbal products can cause problems with surgery, including bleeding and problems with anesthesia. Stop using herbal products at least 2 weeks before surgery, or sooner if your doctor recommends it.

What are possible side effects of herbal products and supplements?
Many herbal products can cause side effects.

Can herbal health products or supplements change the way prescription or OTC drugs work?
Yes. Herbal health products or supplements can affect the way the body processes drugs. When this happens, your medicine may not work the way it should. For example, St. John's wort reduces the amount of certain drugs absorbed by the body. This may mean the drugs aren't absorbed at high enough levels to help the conditions for which they are prescribed. This can cause serious problems.
You should be especially cautious about using herbal health products or supplements if you take a drug in one of the following categories:

1. Drugs to treat depression, anxiety or other psychiatric problems
• Anti-seizure drugs
• Blood thinners
• Blood pressure medicine
• Heart medicine
2. Drugs to treat diabetes
• Cancer drugs
  

If you take any of these drugs, talk to your doctor before taking any type of herbal product or supplement.

Can herbal health products and supplements cause other problems?
Yes. Herbal products and supplements may have other effects that aren't listed above. A few examples include the following:
Glucosamine products may contain sodium. If you're on a low-sodium diet, talk to your doctor before taking glucosamine.
People who are allergic to shellfish may also be allergic to glucosamine. If you have a shellfish allergy, check with your doctor before taking glucosamine.
Don't drink alcohol if you take kava products. Kava can increase the effects of alcohol.
The phytoestrogen black cohosh contains salicylates, so avoid it if you are sensitive to aspirin or other salicylates.
Also, you shouldn't take more than the recommended dose of any herbal health product or supplement. The problems that these products can cause are much more likely to occur if you take too much or take them for too long.
(AAFP)