Diseases

Supplements (Vitamins and Calcium Supplements) Information

Calcium

What is calcium, and what does it do?Most people know that calcium is needed for strong bones, but it's also needed to help blood vessels and muscles contract and expand, to send messages through the nervous system, and to secrete hormones and enzymes. This is the most abundant mineral in your body and makes up 1%-2% of adult human body weight. Over 99% of it is stored in bones and teeth with the rest stored in blood, muscle, and other tissues.How much do you need to consume?There is a great deal of concern over Americans not meeting the recommendations for calcium intake. The recommendations for calcium are listed as an Adequate Intake:AgeAdequate Intake for Calcium0 to 6 months*210 mg from breast milk 315 mg from formula7 to 12 months*270 mg from breast milk 335 mg from formula1 to 3 years500 mg4 to 8 years800 mg9 to 13 years1,300 mg14 to 18 years1,300 mg19 to 50 years1,000 mg51+ years1,200 mg*Breast milk has been shown to have a higher rate of calcium absorption than formula, so calcium requirements are higher for formula-based diets. Calcium needs during pregnancy and lactation do not change from ages 14 to 50.What are sources of calcium?Calcium is found in a variety of foods, but the amount that your body absorbs varies. Oxalic acid and phytic acid both interfere with the absorption of calcium. Foods rich in oxalic acid are spinach, rhubarb, sweet potatoes, and beans. Foods rich in phytic acid are unleavened bread, nuts, seeds, and raw beans. You will absorb some of the calcium in these foods, but not as much as you would from foods that do not contain oxalic acid or phytic acid. For example, calcium absorption from dried beans is about half of what you absorb from milk, and calcium absorption from spinach is about one-tenth of that absorbed from milk. There is no need to omit these foods from your diet. Instead, consume a variety of calcium-rich foods throughout the day.According to the USDA Nutrient Database, the calcium content of some common foods is shown below:FoodAmountCalcium ContentCheese, cheddar1 ½ oz shredded306 mgCollards, frozen, boiled1 cup357 mgCottage cheese, 1% milk fat1 cup138 mgMilk, nonfat1 cup306 mgPowdered milk, nonfat1 tbsp50 mg-100 mgSalmon, canned with bones3 oz181 mgSardines, canned in oil, with bones3 oz324 mgSoy milk1 cup93 mgTofu, soft, made w/calcium sulfate½ cup138 mgYogurt, plain, low-fat1 cup415 mgYogurt, fruit, low-fat1 cup245 mg-385 mgYou can also increase your calcium intake by

• adding nonfat powdered milk to cereals (hot and cold), soups, gravy, baked goods, or casseroles,
• using nonfat milk in place of water in recipes (pancakes, pudding, hot cereals, and mashed potatoes), and
• having yogurt dips for vegetable and chips.

Folic Acid

What is folic acid, and what does it do? Folic acid is the man-made form of folate, a naturally occurring B vitamin. Because it's a water-soluble vitamin, it cannot be stored in the body so it needs to be supplied on a continuous basis. Folic acid helps form and maintain new cells. It is needed to make red blood cells and for the metabolism of homocysteine. It helps produce DNA, and it helps prevent changes in DNA that may lead to cancer. How much do I need to consume? The Recommended Dietary Allowances (RDA) for folate are expressed in a term called Dietary Folate Equivalent (DFE). The naturally occurring folate is absorbed differently than the man-made folic acid, so the DFE was developed to help account for these differences. One DFE is equal to 1 microgram (mcg) of food folate and 0.6 mcg of folic acid from supplements and fortified foods. The RDA for folate: Age Males and Females Pregnancy Lactation 1 to 3 years 150 mcg N/A N/A 4 to 8 years 200 mcg N/A N/A 9 to 13 years 300 mcg N/A N/A 14 to 18 years 400 mcg 600 mcg 500 mcg 19+ years 400 mcg 600 mcg 500 mcg There is insufficient information to establish an RDA for folate for infants. In this case, an Adequate Intake (AI) has been established: Age Males and Females 0 to 6 months 65 mcg 7 to 12 months 80 mcg What are sources of folic acid? Folate can be found naturally in many foods, including fruits, leafy green vegetables, and dried beans. Folic acid is added to certain foods because of regulations published by the Food and Drug Administration in 1996. These foods are considered enriched because the folic acid is replacing the folate that was lost during processing. Some common folic acid-enriched foods are cereals, breads, pasta, rice, flours, and cornmeal. Folic acid can also be added to foods and beverages in addition to the nutrients that they already contain. These foods are considered fortified with folic acid. In 1998, the folic acid fortification program was initiated to help Americans reach their folic acid recommendations. Food sources of folate and folic acid are: Food Amount Folate/Folic Acid Content Asparagus, cooked 4 spears 85 mcg Avocado, sliced, raw ½ cup 45 mcg Banana, raw 1 medium 20 mcg Beef liver 3 oz 185 mcg Broccoli, chopped, frozen, cooked ½ cup 50 mcg Broccoli, raw 2 spears 45 mcg Cantaloupe, raw ¼ medium 25 mcg Great Northern beans ½ cup 90 mcg Green peas, frozen, cooked ½ cup 50 mcg Papaya, raw, cubes ½ cup 25 mcg Rice, white, enriched, cooked ½ cup 65 mcg Spinach, frozen, cooked ½ cup 100 mcg Spinach, raw 1 cup 60 mcg Tomato juice 6 oz 35 mcg Do I need to take a folic acid supplement? The goal is to consume a balanced diet that provides your daily folate needs. The folate-enriched and -fortified foods make this much easier to accomplish. When you have a medical condition that interferes with the amount that you can consume, if you are unable to absorb all of what you consume, if your diet is limited, or if you have an increased need for folate, a supplement would be the best option. It is recommended that women who may become pregnant take 400 mcg of folic acid from fortified foods and/or dietary supplements along with consuming a well-balanced diet. Another possible reason to take a supplement would be for heart protection. There are some studies that have shown that folic acid can lower homocysteine levels by up to 25%. High blood levels of homocysteine can damage the inner surface of blood vessels, promote blood clotting, accelerate atherosclerosis, and thus lead to heart attacks and strokes. What happens if I don't have enough folic acid? One very severe consequence of not getting enough folic acid is the possibility of neural tube defects during pregnancy. Neural tube defects usually develop in the first 28 days of pregnancy. Many women do not know that they are pregnant during this time and are not monitoring their folic acid intake. For this reason, it's a good idea to make sure that you have an adequate daily intake before trying to conceive. A deficiency in folate can lead to megaloblastic (or macrocytic) anemia. It may also cause poor growth, gray hair, glossitis, mouth ulcers, diarrhea, and peptic ulcers. Studies have shown that low blood folate levels are associated with high blood homocysteine levels. High blood levels of homocysteine can damage the inner surface of blood vessels, promote blood clotting, accelerate atherosclerosis, and thus lead to heart attacks and strokes. There are medical conditions and medications that can increase the need for folate, increase its excretion, or interfere with its utilization:

• pregnancy and lactation,
• liver disease,
• kidney dialysis,
• malabsorption,
• alcohol abuse,
• triamterene,
• barbiturates,
• anticonvulsant medications,
• sulfasalazine,
• metformin, and
• methotrexate.

Niacin

What is niacin, and what does it do? Niacin is a water-soluble B vitamin that is also known as vitamin B3, nicotinamide, or nicotinic acid. Niacin assists in the proper functioning of the nervous and digestive system, maintaining healthy skin, and conversion of food to energy. How much niacin do I need to consume? There is insufficient information to establish an RDA for niacin for infants. In this case, an Adequate Intake (AI) has been established: Age Males and Females 0 to 6 months 2 mg 7 to 12 months 4 mg The Recommended Dietary Allowance (RDA) for niacin is: Age Males Females Pregnancy Lactation 1 to 3 years 6 mg 6 mg N/A N/A 4 to 8 years 8 mg 8 mg N/A N/A 9 to 13 years 12 mg 12 mg N/A N/A 14 to 18 years 16 mg 14 mg 18 mg 17 mg 19+ years 16 mg 14 mg 18 mg 17 mg What are sources of niacin? Niacin is found in animal products, nuts, green vegetables, legumes, and enriched and fortified cereals. Food Amount Niacin Content Bagel 4" 3.06 mg Barley, pearled, cooked 1 cup 3.24 mg Beans, kidney, red, boiled 1 cup 1.02 mg Beef, eye of round, roasted 3 oz 5.24 mg Bread, rye 1 slice 1.22 mg Carrots, cooked 1 cup 1.01 mg Cereal, fortified 1 cup 5.00 mg Ham, sliced, extra lean 2 slices 2.23 mg Mango, raw 1 mango 1.21 mg Milk, nonfat 1 cup 0.23 mg Peanut butter, smooth 1 tablespoon 2.14 mg Peas, frozen, cooked 1 cup 2.37 mg Potato, no skin 1 cup 2.05 mg Rice, brown, long-grain, cooked 1 cup 2.98 mg Soybeans, cooked 1 cup 2.25 mg Tomato, canned, sauce 1 cup 2.39 mg Do I need to take a niacin supplement? A well-balanced diet can provide enough niacin to reach your needs. When you have a medical need, a deficiency, or an inadequate diet, you should consult with your physician before taking a niacin supplement. High doses must be prescribed by a physician since niacin can be used as a drug (see below). Niacin supplements come in several forms: niacin, inositol hexaniacinate, and niacinamide What happens if I don't have enough niacin? Niacin was discovered in low-income populations where corn products were the primary source of calories, and the disease pellagra was occurring. The symptoms of pellagra are known as the four Ds: dermatitis, diarrhea, dementia, and death. Pellagra occurs at the late stage of niacin deficiency. Niacin deficiency symptoms will involve the digestive system (diarrhea, vomiting, and bright red tongue), the skin (thick, scaly skin and dark pigmented rash that develops symmetrically in areas exposed to sunlight), and the nervous system (fatigue, depression, headache, apathy, disorientation, and memory loss). Is there such a thing as too much niacin? Doses much higher than the ULs are used medically to improve cholesterol levels. High doses of niacin can cause dangerous liver inflammation, peptic ulcers, and skin rashes. "Niacin flushing" is a side effect that causes redness, itching, and burning and can occur within 10 to 15 minutes after taking it and can last up to one hour. Research has shown that there are conditions that make people susceptible to these symptoms, including diabetes mellitus, gout, cardiac arrhythmias, hepatic dysfunction or a history of liver disease, migraine headaches, alcoholism, and inflammatory bowel disease. These conditions may not be protected by the UL that has been set for the general population, so extreme caution needs to be used when taking niacin supplements. For everyone, the only time that high doses of niacin should be taken would be under the supervision of your physician. The Tolerable Upper Limit (UL) for niacin is:

Riboflavin

What is riboflavin, and what does it do? Riboflavin is one of the water-soluble B vitamins and is also known as vitamin B2. It is needed for converting food to energy, works as an antioxidant by scavenging damaging free radicals, and is needed to convert vitamin B6 and folate into active forms. How much riboflavin do I need to consume? There is insufficient information to establish an RDA for vitamin riboflavin for infants. In this case, an Adequate Intake (AI) has been established: Age Males and Females 0 to 6 months 0.3 mg 7 to 12 months 0.4 mg The Recommended Dietary Allowance (RDA) for riboflavin is: Age Males Females Pregnancy Lactation 1 to 3 years 0.5 mg 0.5 mg N/A N/A 4 to 8 years 0.6 mg 0.6 mg N/A N/A 9 to 13 years 0.9 mg 0.9 mg N/A N/A 14 to 18 years 1.3 mg 1.0 mg 1.4 mg 1.6 mg 19 + years 1.3 mg 1.1 mg 1.4 mg 1.6 mg What are sources of riboflavin? Though riboflavin can be found in most animal and plant foods, it is destroyed by light, so these foods need to be stored away from light to protect it. It can be lost in the water if foods are boiled or soaked, so avoid doing this or consume the water along with the food (for example, soup). Food Amount Riboflavin Content Asparagus, cooked 4 spears 0.08 mg Broccoli, cooked 1 cup 0.15 mg Cereal, fortified 1 cup 0.42 mg Egg, cooked 1 large 0.24 mg Milk, nonfat 1 cup 0.45 mg Nuts, cashews, dry roasted 1 oz 0.06 mg Peaches, raw 1 cup 0.05 mg Peas, frozen, cooked 1 cup 0.16 mg Raisins seedless 1 cup 0.18 mg Spaghetti, cooked, enriched 1 cup 0.19 mg Spinach, cooked 1 cup 0.43 mg Do I need to take a riboflavin supplement? A well-balanced diet can provide enough riboflavin to reach your RDA. When your diet is limited in variety or you have a medical condition that interferes with the absorption of riboflavin, you may need a supplement. The most common forms of riboflavin found in supplements are riboflavin 5-monophosphate and riboflavin. These can be purchased alone, in a multivitamin, or in a B complex supplement. What happens if I don't have enough riboflavin? Riboflavin deficiency can occur from not consuming enough in your diet and from conditions that decrease the amount absorbed, including malabsorption syndromes, chronic diarrhea, long-term use of barbiturates, peritoneal dialysis, and alcoholism. Ariboflavinosis is caused by riboflavin deficiency. The symptoms include fatigue, cracks and sores around the corners of the mouth (angular stomatitis/cheilosis), eye fatigue, swollen magenta tongue (glossitis), skin irritation (dermatitis), soreness and swelling of the throat, sensitivity to light, and eye fatigue. Is there such a thing as too much riboflavin? No Tolerable Upper Limit (UL) has been set for riboflavin. Possible reactions to very high doses include burning/prickling sensations, itching, numbness, and yellow discoloration of the urine. There is also a possibility that riboflavin's photosensitizing (sensitivity to light) properties can pose health risks.

Thiamin (vitamin B1)

What is thiamin, and what does it do? Thiamin is another one of the water-soluble B vitamins. It was previously known as vitamin B1 or aneurine and can also be spelled thiamine. Thiamin is involved in numerous functions:

• metabolism of carbohydrates,
• nervous system functioning,
• producing hydrochloric acid,
• muscle functioning,
• flow of electrolytes in and out cells, and
• multiple enzyme processes.

• 20%-35% lost in water that is discarded after cooking vegetables,
• 43% loss in pork loin that is roasted (three times as much as lost during braising),
• 15% loss in bread that is baked, and
• no loss in double broiler cooking of whole grain cereals.

Vitamin A

What is it, and what does it do? Vitamin A is a fat-soluble vitamin that is broken down into two categories: preformed vitamin A comes from animal foods, and provitamin A carotenoid comes from plant foods. Vitamin A serves many functions:

• helps regulate the immune system to prevent and fight infections
• helps form and maintain healthy teeth, skin, and tissues
• produces the pigments in the retina of the eye
• promotes good vision

Vitamin B12

What is it, and what does it do? Vitamin B12 is needed for producing and maintaining new cells, including nerve cells and red blood cells. It is also needed to help make DNA. Vitamin B12 is bound to the proteins in food. Once you consume B12, the hydrochloric acid in your stomach releases the B12 from the protein. B12 then combines with a substance called intrinsic factor to be absorbed by the intestines. How much do I need to consume? There is insufficient information to establish an RDA for vitamin B12 for infants. In this case, an Adequate Intake (AI) has been established: Age Males and Females 0 to 6 months 0.4 mcg/day 7 to 12 months 0.5 mcg/day The Recommended Dietary Allowance (RDA) for vitamin B12 is: Age Males and Females Pregnancy Lactation 1 to 3 years 0.9 mcg N/A N/A 4 to 8 years 1.2 mcg N/A N/A 9 to 13 years 1.8 mcg N/A N/A 14 to 19 years 2.4 mcg 2.6 mcg 2.8 mcg 19+ years 2.4 mcg/day 2.6 mcg/day 2.8 mcg/day What are sources of vitamin B12? Vitamin B12 is attached to the proteins in animal foods. Breakfast cereals are fortified with vitamin B12, which is very important for people who do not consume an adequate amount of animal foods. Food Amount Vitamin B12 Beef, top sirloin, lean, choice, broiled 3 oz 2.4 mcg Breakfast cereals, fortified ¾ cup 6 mcg Chicken, breast, cooked ½ breast 0.3 mcg Egg 1 large 0.6 mcg Haddock, cooked 3 oz 1.2 mcg Liver, beef 1 slice 47.9 mcg Milk 1 cup 0.9 mcg Mollusks, clam 3 oz 84.1 mcg Salmon, sockeye, cooked 3 oz 4.9 mcg Trout, rainbow, farmed, cooked 3 oz 4.2 mcg Trout, rainbow, wild, cooked 3 oz 5.4 mcg Tuna, white, canned in water 3 oz 1.0 mcg Yogurt, plain, skim 1 cup 1.4 mcg Do I need to take a vitamin B12 supplement? Studies reveal that the majority of Americans consume an adequate amount of vitamin B12. People who do not consume meat or who have a stomach or intestinal disorder that interferes with absorption may need to take a vitamin B12 supplement. Older adults may have atrophic gastritis and may need to consume additional food sources and/or supplements. There are also some medications that can influence vitamin B12 absorption, including H2 receptor antagonists used to treat peptic ulcers, metformin, and proton pump inhibitors. Your doctor can determine your vitamin B12 levels with a blood test. What happens if I don't have enough vitamin B12? An inadequate amount of vitamin B12 can cause pernicious anemia. Signs of vitamin B12 deficiency are fatigue, constipation, weakness, loss of appetite, weight loss, and numbness and tingling in the hands and feet. You may also experience a difficulty in maintaining balance, confusion, dementia, depression, and poor memory. An excess intake of folate can mask the symptoms of B12 deficiency, so it's important to have your levels checked with blood tests if there is a concern, especially if you consume a vegetarian diet. Is there such a thing as too much vitamin B12? Currently, there is no Tolerable Upper Limit set for vitamin B12. This does not mean that consuming excessive amounts will provide any additional health benefits. It means that there is a very low potential for toxicity at high levels.

Vitamin B6

What is vitamin B6, and what does it do? Vitamin B6 is one of the water-soluble B vitamins. It comes in three forms: pyridoxine, pyridoxal, and pyridoxamine. It serves numerous functions in your body, including

• red blood cell metabolism,
• making hemoglobin,
• assisting in the proper functioning of the nervous system,
• assisting in the proper functioning of the immune system,
• protein metabolism, and
• synthesis of serotonin and norepinephrine.

Vitamin C

What is it, and what does it do? Vitamin C, also known as ascorbic acid, is a water-soluble antioxidant vitamin. Vitamin C is required for the synthesis of collagen and dentin. Collagen is the structural component of blood vessels, bones, ligaments, and tendons, while dentin is the structural component of teeth. Vitamin C is also an effective antioxidant that protects proteins and genetic materials (RNA and DNA) from damage by free radicals. Vitamin C cannot be made or stored by your body, so it's important to consume a well-balanced diet containing vitamin C. How much do I need to consume? There is insufficient information to establish an RDA for vitamin C for infants. In this case, an Adequate Intake (AI) has been established: Age Males and Females 0 to 6 months 40 mg/day 7 to 12 months 50 mg/day The Recommended Dietary Allowance (RDA) for vitamin C is: Age Males Females Pregnancy Lactation 1 to 3 years 15 mg 15 mg N/A N/A 4 to 8 years 25 mg 25 mg N/A N/A 9 to 13 years 45 mg 45 mg N/A N/A 14 to 18 years 75 mg 65 mg 80 mg 115 mg 19 + years 90 mg/day 75 mg/day 85 mg/day 120 mg/day What are sources of vitamin C? All fruits and vegetables contain some amount of vitamin C, so consuming a well-balanced diet with plenty of fruits and vegetables is the key. Food Amount Vitamin C Broccoli, cooked ½ cup 37 mg Broccoli, raw ½ cup 39 mg Brussels sprouts, cooked ½ cup 48 mg Cantaloupe ¼ medium 47 mg Cauliflower, cooked ½ cup 28 mg Grapefruit juice ¾ cup 50 mg-70 mg Green pepper, cooked ½ cup 51 mg Green pepper, raw ½ cup 60 mg Guava, raw ½ cup 188 mg Kale, cooked ½ cup 27 mg Kiwi 1 medium 70 mg Mango ½ cup 23 mg Orange 1 medium 70 mg Orange juice ¾ cup 61 mg-93 mg Papaya ¼ medium 47 mg Pineapple, raw ½ cup 28 mg Pod peas, cooked ½ cup 38 mg Red sweet pepper, cooked ½ cup 116 mg Red sweet pepper, raw ½ cup 142 mg Strawberries ½ cup 49 mg Sweet potato, canned ½ cup 34 mg Tomato juice ¾ cup 33 mg Vegetable juice ¾ cup 50 mg Do I need to take a vitamin C supplement? Many people believe that taking vitamin C will help prevent colds. Research has not shown this to be the case. More than 30 clinical trials that included over 10,000 participants have not found any relationship between vitamin C and a reduced risk of colds. There has been a small reduction in the duration of colds, so paying attention to your vitamin C intake once you have the cold is advisable. Research has shown that vitamin C enhances the absorption of iron. For this reason, anyone who needs an iron supplement is usually advised to take it with a food that is high in vitamin C or with a vitamin C supplement. Iron can be toxic at high levels, so speak with your doctor before taking any supplements. There is an increased need for vitamin C for individuals who smoke. There is an additional 35 mg/day requirement for smokers versus nonsmokers. This can be achieved with dietary sources or a supplement. What happens if I don't have enough vitamin C? Scurvy is a severe deficiency of vitamin C. It would be uncommon for most of us, but it can be found in someone who is malnourished. Less severe deficiencies can occur. Not consuming an adequate amount of vitamin C can lead to symptoms, including feeling weak, tired, and irritable, having dry and splitting hair, bleeding gums, rough, dry, and scaly skin, gingivitis, easy bruising, anemia, and a decreased ability to fight infection. Is there such a thing as too much vitamin C? Vitamin C is generally safe. Large doses of vitamin C may cause stomach upset and diarrhea in adults and have been reported to cause kidney stones. There is also a risk of excess iron absorption with high doses of vitamin C.

Vitamin D

What is it, and what does it do?Vitamin D is probably most well-known for being the "sunshine vitamin." The ultraviolet rays from sunlight striking the skin, causing vitamin D to be made. It can also be found in food and supplements. This is one of the four fat-soluble vitamins. That means that it's stored in the body's fatty tissue and can build up to toxic levels with excessive consumption. The current thinking, however, is that the potential toxicity of vitamin D has been exaggerated in the past and it is safe overall.The major function of vitamin D is to maintain optimal blood levels of calcium and phosphorus. Studies have shown that it provides protection from hypertension, cancer, osteoporosis, type 1 diabetes, and several autoimmune diseases.How much do I need to consume?The recommendations for vitamin D are listed as an Adequate Intake in micrograms (mcg) and International Units (IU):AgeVitamin D0-12 months10 mcg (400 IU)1 to 13 years15 mcg (600 IU)14 to 18 years15 mcg (600 IU)19 to 50 years15 mcg (600 IU)50 to 71 years15 mcg (600 IU)71+ years20 mcg (800 IU)What are sources of vitamin D?The sunshine vitamin got its name from the fact that the sun helps our body produce vitamin D. The concern about skin cancer has caused many people to avoid unprotected exposure to the sun. Fortunately, it is possible to consume enough vitamin D in your diet, so it is not necessary to risk the dangers of skin cancer by exposing yourself to the sun. For those who do rely on the sun as one of their sources, there are many factors that will impact how much you need. The season, time of day, cloud coverage, smog, amount and SPF of sunscreen, geographic latitude, and melanin content of your skin are all possible barriers. It can take anywhere from five to 30 minutes of sun on unexposed skin between the hours of 10 a.m. and 3 p.m. at least twice a week.The foods that naturally contain vitamin D are seafood, mushrooms, and egg yolks. Dietary sources of vitamin D are:FoodAmountVitamin D ContentBluefish3 oz415 IUCatfish3 oz425 IUCod liver oil1 teaspoon450 IUEgg yolk1 whole25 IUMackerel3 oz395 IUMilk, vitamin D fortified1 cup100 IUMushrooms, Chanterelle2 oz50 IUMushrooms, Shitake2 oz55 IUOysters3 oz545 IUSalmon, farmed3 oz275 IUSalmon, wild3 oz1,000 IUSardines, canned in oil1 ¾ oz230 IUShrimp3 oz120 IUTuna, bluefin3 oz170 IUTuna, canned in water3 oz135 IUDo I need to take a vitamin D supplement?When diet is not enough, you may need to take a supplement to help you reach the desired intake of vitamin D. As you will see, vitamin D can be toxic at high levels, so the goal is to reach the appropriate level, not exceed it.The two primary types of vitamin D supplements are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Most experts believe that vitamin D3 is the ideal choice for these reasons:

• Vitamin D3 is the most potent form, it's more stable on the shelf, and it's less toxic than D2.
• Vitamin D3 is the one that is synthesized when the sun hits your skin, so it's considered to be the most natural.
• Most of the research that has been done on vitamin D and its health benefits has used vitamin D3.

Vitamin E

What is it, and what does it do? Vitamin E represents a family of eight fat-soluble antioxidant vitamins. Each form has its own function. Alpha-tocopherol is the most important E vitamin in humans. Vitamin E is involved in maintaining cell integrity, and it protects vitamin A and essential fatty acids from oxidation in the body cells. How much do I need to consume? The Recommended Dietary Allowances (RDA) for vitamin E is based on the alpha-tocopherol form. The recommendations below are in milligrams (mg) and International Units (IU). You can use the milligrams when looking at the content in food and the International Units when looking at the content in supplements. The RDA for vitamin E is: Age Males and Females Pregnancy Lactation 1 to 3 years 6 mg (9 IU) N/A N/A 4 to 8 years 7 mg (10.5 IU) N/A N/A 9 to 13 years 11 mg (16.5 IU) 15 mg (22.5 IU) 19 mg (28.5 IU) 14 + years 15 mg (22.5 IU) 15 mg (22.5 IU) 19 mg (28.5 IU) There is insufficient information to establish an RDA for vitamin E for infants. In this case, an Adequate Intake (AI) has been established: Age Males and Females 0 to 6 months 4 mg (6 IU) 7 to 12 months 5 mg (7.5 IU) What are sources of vitamin E? There are many foods rich in vitamin E. The most common ones are fortified cereals, green leafy vegetables, vegetable oil, eggs, and nuts. The content of vitamin E in food is based on the alpha-tocopherol content: Food Amount Vitamin E Alpha-tocopherol Almonds, dry roasted 1 oz 7.4 mg Broccoli, frozen, cooked ½ cup 1.2 mg Corn oil 1 tablespoon 1.9 mg Egg 1 large 5.3 mg Kiwi, no skin 1 medium 1.1 mg Mango, raw ½ cup sliced 0.9 mg Peanut butter, smooth style, fortified 2 tablespoons 4.2 mg Safflower oil 1 tablespoon 4.6 mg Soybean oil 1 tablespoon 1.3 mg Spinach, frozen, cooked ½ cup 1.6 mg Spinach, raw 1 cup 0.6 mg Sunflower oil 1 tablespoon 5.6 mg Sunflower seed kernels, dry roasted 1 oz 6.0 mg Wheat germ oil 1 tablespoon 20.3 mg Do I need to take a vitamin E supplement? Most research shows that we do not consume an adequate amount of vitamin E, but a deficiency is rare. According to the USDA, the intake of vitamin E by women 19 to 50 years is less than 90% of the RDA. The average consumption for American adults is 7 to 9 mg compared to the recommended 15 mg. There is, however, a possibility that we are consuming more than we think. Many people under-report their fat intake, so there is a chance that you are reaching your recommended amount of vitamin E if you do consume a large amount of the oils that contain it. Unfortunately, the amount of oil that it would take to reach the recommendations is high, and with that comes a lot of calories. It would be best to consume a variety of the foods that contain vitamin E with limited amounts of oil and take a supplement for what you are missing. There is some evidence that vitamin E supplements help protect against heart disease, but this evidence is controversial. In a study of approximately 90,000 nurses, the incidence of heart disease was 30%-40% lower in those with the highest intake of vitamin E from supplements, not from food. This study was looking at what happened to these nurses without any kind of intervention. The studies that gave people vitamin E supplements have not seen any protection against heart disease. The reason for the difference is still unclear, so there is more research being done to determine what role vitamin E plays in protecting against heart disease. At this time, the American Heart Association does not recommend antioxidant vitamins -- including vitamin E -- for preventing cardiovascular disease. Some cancers develop from oxidation damage to DNA. In the Alpha-Tocopherol Beta Carotene (ATBC) study, scientists found a 32% reduction in the incidence of prostate cancer among subjects taking alpha-tocopherol supplements compared to those not taking the vitamin. However, several studies have found no benefit of vitamin E in preventing lung and breast cancers. More randomized controlled trials are needed to determine the effect of vitamin E on cancer risks. Alzheimer's disease is a degenerative brain disease with progressive loss of mental capacity, thought in part to be due to oxidation. High doses of alpha-tocopherol supplementation in one study slowed the progression of Alzheimer's disease. Although these results are promising, large-scale placebo-controlled prospective trials will be required to determine the role of a-tocopherol supplementation in the treatment of Alzheimer's disease. When purchasing vitamin E supplements, you will see that they are often sold as alpha-tocopheryl acetate. This form of alpha-tocopherol protects its ability to function as an antioxidant. A "DL" on the label means that it's the synthetic form and is about half as active as the natural form, which is listed as "D." What happens if I don't have enough vitamin E? Dietary vitamin E deficiency is common in developing countries and among people with fat-malabsorption diseases. The main symptoms are hemolytic anemia and neurologic deficits. Is there such a thing as too much vitamin E? Vitamin E can act as an anticoagulant, which means that it can increase the risk of bleeding problems. This means that people taking warfarin (Coumadin) should not take vitamin E supplements without their doctor's approval. The Tolerable Upper Limit (UL) was set at the highest dose unlikely to result in bleeding problems. There are UL set for vitamin E:

Vitamin K

What is vitamin K, and what does it do? Vitamin K is a fat-soluble vitamin known for its role in blood clotting. There are three main types of vitamin K: vitamin K1 (phytonadione) if the natural form found in plants; vitamin K2 (menaquinones) is made by the human gut; and vitamin K3 (menadione) is the water-soluble form that is made for use in supplements. People taking the blood-thinning medication warfarin (Coumadin) are at an increased risk for blood clotting. Warfarin works by decreasing the activity of vitamin K, lengthening the time it takes for a clot to form. The goal for vitamin K intake while taking warfarin is to keep your intake constant. This does not mean that you can't consume any vitamin K-containing foods. Instead, you want to consume a consistent amount so that the dose of warfarin that you are taking is working on the same amount. Sudden increases and/or decreases in vitamin K while taking warfarin can cause problems. How much vitamin K do I need to consume? There is no data to establish RDAs for vitamin K. Therefore, Adequate Intakes (AI) have been established: Age Males Females Pregnancy Lactation 0 to 6 months 2.0 mcg 2.0 mcg N/A N/A 7 to 12 months 2.5 mcg 2.5 mcg N/A N/A 1 to 3 years 30 mcg 30 mcg N/A N/A 4 to 8 years 55 mcg 55 mcg N/A N/A 9 to 13 years 60 mcg 60 mcg N/A N/A 14 to 18 years 75 mcg 75 mcg 75 mcg 75 mcg 19+ years 120 mcg 90 mcg 90 mcg 90 mcg What are sources of vitamin K? Vitamin K is found primarily in green leafy vegetables and fruit. It can also be found in some animal foods. Food Amount Vitamin K Content Banana 1 medium 0.6 mcg Beans, kidney, red, cooked 1 cup 14.9 mcg Blueberries, raw 1 cup 28 mcg Broccoli, raw 1 cup 89.4 mcg Brussels sprouts, frozen, cooked 1 cup 299.9 mcg Cabbage, cooked, boiled 1 cup 163.1 mcg Carrot juice, canned 1 cup 36.6 mcg Collards, frozen, chopped, cooked 1 cup 1,059 mcg Dandelion greens, cooked 1 cup 579.0 mcg Endive, raw 1 cup 115.5 mcg Kale, frozen, cooked 1 cup 1,146.6 mcg Lettuce, green leaf, raw 1 cup 97.2 mcg Mustard greens, cooked 1 cup 419.3 mcg Onions, spring or scallion 1 cup 207.0 mcg Spinach, frozen, cooked 1 cup 1,027.3 mcg Turnip greens, frozen, cooked 1 cup 851.0 mcg Do I need to take a vitamin K supplement? A well-balanced diet can provide an adequate amount of vitamin K. There are conditions that can interfere with the absorption of vitamin K, including celiac disease, ulcerative colitis, cystic fibrosis, biliary obstruction, regional enteritis, or intestinal resection. Medications that alter your liver function or kill the intestinal flora can also negatively impact your vitamin K levels. These medications include antibiotics, antiseizure medications, salicylates, and some sulfa drugs. What happens if I don't have enough vitamin K? Vitamin K is needed by the liver to make factors that are necessary for blood to clot properly. A deficiency in vitamin K can lead to defective blood clotting and increased bleeding. Is there such a thing as too much vitamin K? The Tolerable Upper Limit (UL) for vitamin K has not been established. Amounts exceeding 1,000 times the AI can promote formation of blood clots (thrombogenesis), breakdown of red blood cells (hemolysis), and raise the risk of jaundice.