To the typical person who doesn't possess a medical degree or encyclopedic knowledge of nutrition, vitamin supplements seem to make perfect sense. Your body obviously craves vitamins E, A, C, D, all of the many Bs, calcium, niacin, biotin and on and on. If it didn't, why would the foods we try our best to eat each day be packed with them, right?
But there's just one problem. There is such a thing as vitamin and mineral overload, and unless you are incredibly diligent about your daily intake of nutrients — and I'm talking about having down to the letter knowledge of how many milligrams of everything you're ingesting — it's difficult to tell whether you're actually deficient in certain vitamins and minerals. Similar to how you wouldn't (I hope) open your medicine cabinet and kick back pills just because you suspect you might need a blood thinner or cholesterol medication, you shouldn't buy out all the calcium supplements at your pharmacy because you fear your hatred of milk will result in weak bones.
"There are some cases where vitamins may not be necessary and in fact harmful when you have certain conditions," says Dr. Scott Michael Schreiber, a chiropractic physician, certified nutrition specialist and licensed dietitian/nutritionist. "All women should not take vitamins, and their requirement for certain nutrients change throughout life. I recommend that before women start taking vitamins, they see a nutrition expert to determine if there is any need and definitely do not diagnose yourself with any diseases without the proper workup."
Exceeding the recommended daily allowance can result in mild side effects like stomach upset, diarrhea, constipation, nausea and vomiting. Or it can cause more serious effects, like kidney stones, anemia, birth defects, liver damage and other organ impairments, according to Dr. Sherry Ross — OB-GYN and women's health expert at Providence Saint John's Health Center in Santa Monica, California. "When vitamins are taken in toxic doses for prolonged periods of time irreversible organ damage can occur," Ross says. "From gallstones to nerve damage, supplements may be an over the counter supplement, but make sure you properly educate yourself from reputable sources or your health care provider."
Just to give you some idea of more specific side effects that can occur, Lindsay Langford — registered dietitian and board certified in sports dietetics at St. Vincent Sports Performance — breaks down the possible symptoms you may experience if you consume too much niacin and vitamin C (the latter is especially popular and present in lots of supplements and drinks).
"Consumption of niacin, in supplemental or fortified food form, above the max tolerance level is associated with flushing and tingling," Langford says. "Overconsumption of vitamin C may cause diarrhea, which while unpleasant is much less severe than niacin. For the most part, you only have to worry about vitamins/minerals becoming harmful when you're talking about supplementation with an individual vitamin/mineral and really when someone is taking large doses."
Most experts agree that, while it's always preferable to get your minerals and vitamins from a balanced diet rich in vegetables and protein, a once-a-day multivitamin helps cover the bases in a safe mannner. "The problem is the average diet can leave gaps in your daily nutritional requirements, which means you are missing out on vital elements your body needs to function optimally," Ross says. "Taking a complete multi-vitamin serves as a perfect insurance policy ensuring you are getting what is missing from your diet."
Other times when women should take extra vitamins include while trying to get pregnant and during pregnancy and breastfeeding — when higher amounts of folic acid, vitamins and minerals, such as calcium, iron, vitamin D and B-complex vitamins, are needed, Ross says. Women older than 50 often need additional calcium and vitamin D for osteoporosis prevention, she says.
Outside of this, and what a nutritionist says you are deficient in, you shouldn't feel a need to have a cabinet packed with supplements.
And anyone who is on medication such as aspirin, blood thinners, steroids, heart and immune-suppressing medications should always ask their health care provider if vitamin supplements are safe — particularly if you are planning to have surgery because vitamins can cause excessive bleeding and other complications.
The bottom line: "For healthy women, a one-a-day multivitamin from a reputable vitamin manufacturer would typically be considered safe and would not need a doctor's approval," Ross says. "For those with medical problems or who are taking medication, I recommend you speak with your health care provider before taking any vitamin supplements."
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