Vitamines and Minerals

Handhaaf ‘n gesonde en gebalanseerde lewe en probeer sover moontlik gesonde groentes, vrugte en vleise in te neem en vul waar nodig aan.  Dis belangrik om met u apteker of dokter oor ekstra aanvullings te kommunikeer,  waar nodig.    Daar moet altyd opgelet word om ekstra vitamines aan te wend met die idee om gesondheid te verbeter en nie om teveel in te neem wat die gesondheid kan benadeel of erge pyne kan veroorsaak nie.   Wees versigtig vir teveel aanvullings wat nadelig kan wees vir die gesondheid.   ‘n Paar webtuistes en inligting is hierin vervat.

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When consumed naturally through foods, these nutrients are unlikely to cause harm, even when consumed in large amounts.   When taken in concentrated doses in supplement form, it’s easy to take too much, and doing so can lead to negative health outcomes.     Water-soluble vitamins are readily excreted from the body and not easily stored in tissues. There are more water-soluble vitamins than there are fat-soluble ones.

Water-soluble vitamins include vitamin C, plus eight B vitamins:

• Vitamin B1 (thiamine)
• Vitamin B2 (riboflavin)
• Vitamin B3 (niacin)
• Vitamin B5 (pantothenic acid)
• Vitamin B6 (pyridoxine)
• Vitamin B7 (biotin)
• Vitamin B9 (folate)
• Vitamin B12 (cobalamin)

Because water-soluble vitamins aren’t stored but rather excreted through urine, they’re less likely to cause issues even when taken in high doses.   However, taking megadoses of some water-soluble vitamins can lead to potentially dangerous side effects.  For example, taking very high doses of vitamin B6 can lead to potentially irreversible nerve damage over time, while taking large amounts of niacin — typically in excess of 2 grams per day — can cause liver damage.

Unlike water-soluble vitamins, fat-soluble vitamins do not dissolve in water and are easily stored in your body’s tissues.

There are four fat-soluble vitamins:

• Vitamin A
• Vitamin D
• Vitamin E
• Vitamin K

Given that fat-soluble vitamins can accumulate in the body, these nutrients are more likely to lead to toxicity than water-soluble vitamins.   While rare, taking too much vitamin A, D, or E can lead to potentially harmful side effects.

However, similarly to vitamin K, certain water-soluble vitamins have no observable toxicity and hence no set UL.  These vitamins include vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B5 (pantothenic acid), vitamin B7 (biotin), and vitamin B12 (cobalamin).   It’s important to note that while these vitamins have no observable toxicity, some of them may interact with medications and interfere with blood testing results. Therefore, caution should be taken with all nutritional supplements.

The following water-soluble vitamins have set ULs, as they can cause adverse side effects when taken in high doses:

• Vitamin C. Although vitamin C has relatively low toxicity, high doses of it can cause gastrointestinal disturbances, including diarrhea, cramps, nausea, and vomiting. Migraines can occur at doses of 6 grams per day.
• Vitamin B3 (niacin). When taken in the form of nicotinic acid, niacin can lead to high blood pressure, abdominal pain, impaired vision, and liver damage when consumed in high doses of 1–3 grams per day .
• Vitamin B6 (pyridoxine). Long-term overconsumption of B6 can cause severe neurological symptoms, skin lesions, sensitivity to light, nausea, and heartburn, with some of these symptoms occurring at intakes of 1–6 grams per day.
• Vitamin B9 (folate). Taking too much folate or folic acid in supplement form may affect mental function, negatively impact the immune system, and mask a potentially severe vitamin B12 deficiency.

Aside from vitamin K, which has a low potential for toxicity, the remaining three fat-soluble vitamins have a set UL due to their potential to cause harm at high doses.    Here are some side effects related to the overconsumption of fat-soluble vitamins:

• Vitamin A. While vitamin A toxicity, or hypervitaminosis A, can occur from eating vitamin-A-rich foods, it’s mostly associated with supplements. Symptoms include nausea, increased intracranial pressure, coma, and even death.
• Vitamin D. Toxicity from taking high doses of vitamin D supplements can lead to dangerous symptoms, including weight loss, appetite loss, and irregular heartbeat. It can also raise blood calcium levels, which can lead to organ damage.
• Vitamin E. High-dose vitamin E supplements may interfere with blood clotting, cause hemorrhages, and lead to hemorrhagic stroke.

Although vitamin K has a low potential for toxicity, it can interact with certain medications, such as warfarin and antibiotics.

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Age, genetic disorders, medical conditions, and diet are all factors that can increase the need for certain nutrients.    Fortunately, vitamins are typically safe to take as long as they are used responsibly.   The following chart outlines both the recommended daily intake (RDI) and tolerable upper intake levels (UL) for fat-soluble and water-soluble vitamins.

Due to potential toxicity, it’s not recommended to consume more than the tolerable upper intake levels set for the nutrients listed above.

https://www.healthline.com/nutrition/can-you-overdose-on-vitamins#risks-of-high-doses

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Table 1: Macronutrient Recommendations from Selected Regions/Countries (Compiled by CE Naude)

Table 2: The South African Food Based Dietary Guidelines (FBDGs) for healthy adults and children 5 years and older

Healthy foods from all food groups should be consumed on a daily basis, preferably foods from at least 2 groups at each meal. It is important to remember that a single food cannot provide all the nutrients we need for optimal health. Elimination of food groups can lead to deficiencies and disease.

Click to access 2014%20Fact%20Sheet%20-%20Dietary%20Guidelines%20for%20Health%20Final.pdf

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Measurements for Vitamins and Minerals

Vitamins and minerals are measured in a variety of ways. The most common are:

• mg – milligram (a milligram is one thousandth of a gram)
• mcg – microgram (a microgram is one millionth of a gram. 1,000 micrograms is equal to one milligram)
• IU – international unit (the conversion of milligrams and micrograms into IU depends on the type of vitamin or drug)

Vitamins help your body grow and work the way it should. There are 13 essential vitamins — vitamins A, C, D, E, K, and the B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, B₆, B₁₂, and folate).

Vitamins have different jobs to help keep the body working properly. Some vitamins help you resist infections and keep your nerves healthy, while others may help your body get energy from food or help your blood clot properly. By following the Dietary Guidelines, you will get enough of most of these vitamins from food.

Like vitamins, minerals also help your body function. Minerals are elements that our bodies need to function that can be found on the earth and in foods. Some minerals, like iodine and fluoride, are only needed in very small quantities. Others, such as calcium, magnesium, and potassium, are needed in larger amounts. As with vitamins, if you eat a varied diet, you will probably get enough of most minerals.

https://www.nia.nih.gov/health/vitamins-and-minerals-older-adults

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Eating more fresh vegetables and fruit also helps — they are naturally low in sodium and provide more potassium. Get your sauce and dressing on the side and use only as much as you need for taste.

https://www.nia.nih.gov/health/vitamins-and-minerals-older-adults

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Copper

Copper is an essential mineral that has many roles in the body.   It helps maintain a healthy metabolism, promotes strong and healthy bones and ensures your nervous system works properly.    Other causes of copper deficiency are celiac disease, surgeries affecting the digestive tract and consuming too much zinc, as zinc competes with copper to be absorbed.   Copper deficiency may be one of the many causes of fatigue and weakness. Osteoporosis is a condition characterized by weak and brittle bones.  When copper levels are low, your body may struggle to make immune cells. This could drastically reduce your white blood cell count, compromising your body’s ability to combat infection. That’s because copper plays an important role in brain function and development.  People with copper deficiency may find it harder to walk properly.  Enzymes use copper to maintain optimal health of the spinal cord. Some enzymes help insulate the spinal cord, so signals can be relayed between the brain and body.    Copper is used by enzymes that help maintain a healthy nervous system, ensuring signals are sent efficiently to and from the brain. A deficiency can compromise or delay these signals, causing a loss of coordination or unsteadiness while walking.      People with copper deficiency may feel more sensitive to cooler temperatures.   Copper, along with other minerals like zinc, helps maintain optimal thyroid gland function.  Studies have shown that the T3 and T4 levels of thyroid hormones are closely linked to copper levels. When blood copper levels are low, these thyroid hormone levels fall. As a result, the thyroid gland may not work as effectively.  Interestingly, copper is used by enzymes that produce melanin. Therefore, copper deficiency could affect the production of this pigment, causing pale skin.
Vision loss is a serious condition that may occur with long-term copper deficiency.    Copper is used by many enzymes that help ensure the nervous system works properly. This means that copper deficiency can cause problems with the nervous system, including vision loss.   It seems that vision loss due to copper deficiency is more common among people who have had surgery on their digestive tract, such as gastric bypass surgery. This is because these surgeries can reduce the body’s ability to absorb copper.

Copper toxicity can have unpleasant and potentially fatal side effects, including:

• Nausea
• Vomiting (food or blood)
• Diarrhea
• Stomach pain
• Black, “tarry” stools
• Headaches
• Difficulty breathing
• An irregular heartbeat
• Low blood pressure
• Coma
• Yellow skin (jaundice)
• Kidney damage
• Liver damage

https://www.healthline.com/nutrition/copper-deficiency-symptoms

Zinc
When taken by mouth: Zinc is LIKELY SAFE for most adults when taken by mouth in amounts not larger than 40 mg daily. Routine zinc supplementation is not recommended without the advice of a healthcare professional. In some people, zinc might cause nausea, vomiting, diarrhea, metallic taste, kidney and stomach damage, and other side effects.  There is some concern that taking doses higher than 40 mg daily might decrease how much copper the body absorbs. Decreased copper absorption may cause anemia. High doses above the recommended amounts might cause fever, coughing, stomach pain, fatigue, and many other problems.

Zinc is a mineral. It is called an “essential trace element” because very small amounts of zinc are necessary for human health. Since the human body does not store excess zinc, it must be consumed regularly as part of the diet. Common dietary sources of zinc include red meat, poultry, and fish. Zinc deficiency can cause short stature, reduced ability to taste food, and the inability of testes and ovaries to function properly.    
Zinc is used for the treatment and prevention of zinc deficiency and its consequences, including stunted growth and acute diarrhea in children, slow wound healing, and Wilson’s disease. Zinc is also used for many other conditions. There is some scientific evidence to support its use for some of these conditions. But for most, there is no good scientific evidence to support its use.
Zinc is needed for the proper growth and maintenance of the human body. It is found in several systems and biological reactions, and it is needed for immune function, wound healing, blood clotting, thyroid function, and much more. Meats, seafood, dairy products, nuts, legumes, and whole grains offer relatively high levels of zinc.    Zinc deficiency is not uncommon worldwide, but is rare in the US. Symptoms include slowed growth, low insulin levels, loss of appetite, irritability, generalized hair loss, rough and dry skin, slow wound healing, poor sense of taste and smell, diarrhea, and nausea. Moderate zinc deficiency is associated with disorders of the intestine which interfere with food absorption (malabsorption syndromes), alcoholism, chronic kidney failure, and chronic debilitating diseases.
Zinc plays a key role in maintaining vision, and it is present in high concentrations in the eye. Zinc deficiency can alter vision, and severe deficiency can cause changes in the retina (the back of the eye where an image is focused).
Zinc might also have effects against viruses. It appears to lessen symptoms of the rhinovirus (common cold), but researchers can’t yet explain exactly how this works. In addition, there is some evidence that zinc has some antiviral activity against the herpes virus.
Low zinc levels can be associated with male infertility, sickle cell disease, HIV, major depression, and type 2 diabetes, and can be fought by taking a zinc supplement..

https://www.webmd.com/vitamins/ai/ingredientmono-982/zinc

Too much zinc?

Typically, stomach pain and diarrhea occur in conjunction with nausea and vomiting.  Taking more zinc than the established UL may cause flu-like symptoms, such as fever, chills, cough, headache and fatigue.

Zinc-induced copper deficiency is associated with several blood disorders.  Although zinc plays an important role in immune system function, too much zinc can suppress your immune response

Zinc in excess of the recommended levels may also cause taste alterations, including a bad or metallic taste in your mouth.   Zinc and copper compete for absorption in your small intestine.  Zinc and copper is an essential mineral. It aids in iron absorption and metabolism, making it necessary for red blood cell formation. It also plays a role in white blood cell formation.    Red blood cells transport oxygen through your body, while white blood cells are key players in your immune function.

https://www.healthline.com/nutrition/zinc-overdose-symptoms#TOC_TITLE_HDR_2

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Large doses of iron cannot be excreted through urine or faeces and will accumulate in the body. Excess iron is stored in the organs such as the pancreas, liver, and heart and too much iron in the body can lead to nausea, diarrhoea, liver damage, dehydration, and even coma in severe cases.

Too much preformed vitamin A obtained from supplements or medicines can lead to headaches, dizziness, nausea, coma and even death, and an excess of preformed vitamin A in pregnant women may cause birth defects.

However, taking too much vitamin C can irritate the stomach, leading to gastrointestinal problems such as nausea and diarrhoea. A skin rash may also develop with an overload of vitamin C.

However, zinc poisoning can occur from taking too much supplemental zinc and you may experience symptoms such as nausea, headaches, vomiting and diarrhoea.

Health alert: Can you overdose on vitamins and minerals?

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Folate is one of the B-vitamins and is needed to make red and white blood cells in the bone marrow, convert carbohydrates into energy, and produce DNA and RNA. Adequate folate intake is extremely important during periods of rapid growth such as pregnancy, infancy, and adolescence.

Although doses up to 5 mg daily have been safely used in some research, doses of folic acid greater than 1 mg daily might cause abdominal cramps, diarrhea, rash, sleep disorders, irritability, confusion, nausea, stomach upset, behavior changes, skin reactions, seizures, gas, excitability, and other side effects.

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The RDA (Recommended Dietary Allowance) and the AI (Adequate Intake) are the amounts of a vitamin or mineral you need to keep healthy and stay well-nourished. They’re tailored to women, men, and specific age groups.   The UL (Tolerable Upper Intake Level) is the maximum amount of daily vitamins and minerals that you can safely take without risk of an overdose or serious side effects. For certain nutrients, the higher you go above the UL, the greater the chance you’ll have problems.

The DV (Daily Value) is the only measurement you’ll find on food and supplement labels. That’s because space is limited, and there’s a need for one single reference number. That number is the amount of a vitamin or nutrient that you should get for top health from a diet of 2,000 calories a day. The DV is sometimes the same as the RDA.  Although the details may be different, remember that the RDA and DV are both set up to help you get the nutrients you need to prevent disease and avoid problems caused by lack of nutrition.

How Much Is Too Much?

Because high doses of some supplements can have risks, how do you know when it’s OK to take more than the RDA or DV?   One way is to look for the UL (tolerable upper intake level) of a nutrient. With many vitamins and minerals, you can safely take a dose much higher than the RDA or DV without coming close to the UL.

For instance, the average person can take more than 50 times the RDA of vitamin B6 without reaching the upper limit. But some people develop symptoms of nerve pain with these higher levels of B6. So you should always be cautious. Here are some things to keep in mind:

Some supplements are riskier than others. With some vitamins and minerals, the upper limit is pretty close to the RDA. So it’s easy to get too much. For example, a man who takes just over three times the RDA of vitamin A would get more than the upper limit. High doses of vitamin A — and other fat-soluble vitamins like E and K — can build up in the body and become toxic. Other risky supplements include the minerals iron and selenium.

Supplementsare designed to be additions to your diet. Popping pills is not the answer to good health. Experts say you should eat a well-balanced diet and take supplements to fill in any nutritional gaps. Some people take a multivitamin with minerals for nutritional insurance.

The UL is often the limit for all sources of a nutrient. It can include the amount you get from both food and supplements. So when you figure out whether you’ve reached the UL on a particular nutrient, take into account the food you eat.

You won’t find the UL on food nutrition labels or on your vitamin bottle. It’s not a number that most people know about. But you’ll see it on government web sites. And there’s a complete list of nutrients with ULs at the end of this article.

Most supplements don’t have a UL — or RDA or DV. The government has only set levels for a fraction of the vitamins and supplements available. For most of the supplements you see on the shelves, experts really don’t know the ideal or maximum dose.

Many nutrients, in too high a dose, can be dangerous. To be on the safe side, steer clear of the UL for any nutrient. And if you have a health condition, check with your doctor before you take supplements. They can tell you if they have side effects or interfere with other medicines you use.

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Table: RDAs and ULs for Vitamins and Minerals

The Institute of Medicine has determined upper limits for 24 nutrients. This table is for adults ages 19 or older. It doesn’t apply to women who are pregnant or breastfeeding, because they have different nutritional requirements.

Vitamin or Mineral	Recommended Dietary Allowance (RDA) or Adequate Intake (AI) Nutrients with AIs are marked with an (*)	Upper Tolerable Limit (UL) The highest amount you can take without risk
Boron	Not determined.	20 mg/day
Calcium	Age 19-50: 1,000 mg/day Women age 51+: 1,200 mg/day Men age 71+: 1,200 mg/day	Age19-50: 2,500 mg/day Age 51 and up: 2,000 mg/day
Chloride	Age 19-50: 2,300 mg/day Age 50-70: 2,000 mg/day Age 70 and older: 1,800 mg/day	3,600 mg/day
Choline (Vitamin B complex)	Women: 425 mg/day * Men: 550 mg/day *	3,500 mg/day
Copper	900 micrograms/day	10,000 mcg/day
Fluoride	Men: 4 mg/day * Women: 3 mg/day *	10 mg/day
Folic Acid (Folate)	400 mcg/day	1,000 mcg/day This applies only to synthetic folic acid in supplements or fortified foods. There is no upper limit for folic acid from natural sources.
Iodine	150 mcg/day	1,100 mcg/day
Iron	Men: 8 mg/day Women age 19-50: 18 mg/day Women age 51 and up: 8 mg/day	45 mg/day
Magnesium	Men age 19-30: 400 mg/day Men age 31 and up: 420 mg/day Women age 19-30: 310 mg/day Women age 31 and up: 320 mg/day	350 mg/day This applies only to magnesium in supplements or fortified foods. There is no upper limit for magnesium in food and water.
Manganese	Men: 2.3 mg/day * Women: 1.8 mg/day*	11 mg/day
Molybdenum	45 mcg/day	2,000 mcg/day
Nickel	Not determined	1 mg/day
Phosphorus	700 mg/day	Up to age 70: 4,000 mg/day Over age 70: 3,000 mg/day
Selenium	55 mcg/day	400 mcg/day
Sodium	Age 19-50: 1,500 mg/day * Age 51-70: 1,300 mg/day * Age 71 and up: 1,200 mg/day *	2,300 mg/day
Vanadium	Not determined	1.8 mg/day
Vitamin A	Men: 900 mcg/day Women: 700 mcg/day	3,000 mcg/day
Vitamin B3 (Niacin)	Men: 16 mg/day Women: 14 mg/day	35 mg/day This applies only to niacin in supplements or fortified foods. There is no upper limit for niacin in natural sources.
Vitamin B6	Men age 19-50: 1.3 mg/day Men age 51 up:1.7 mg/day Women age 19-50: 1.3 mg/day Women age 51 up: 1.5 mg/day	100 mg/day
Vitamin C	Men: 90 mg/day Women: 75 mg/day	2,000 mg/day
Vitamin D (Calciferol)	Age 1-70: 15 mcg/day (600 IU, or international units) * Age 70 and older: 20 mcg/day (800 IU) *	100 mcg/day (4,000 IU)
Vitamin E (alpha-tocopherol)	22.4 IU/day (15 mg/day)	1,500 IU/day (1,000 mg/day) This applies only to vitamin E in supplements or fortified foods. There is no upper limit for vitamin E from natural sources.
Zinc	Men: 11 mg/day Women: 8 mg/day	40 mg/day

https://www.webmd.com/vitamins-and-supplements/vitamins-minerals-how-much-should-you-take

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