Are supplements really necessary?

There is a growing consensus among health professionals that most people don’t need vitamin supplements. Taking them is said to be a waste of money that will do no more than lead to expensive urine.

The standard advice is to eat a well-balanced diet. No one can argue with that sentiment, but what does it mean? “A well-balanced diet” is rarely defined beyond a vague idea of eating your vegetables. The Department of Agriculture suggests that people should eat between five and nine servings of vegetables and fruits daily. For a person who consumes 2,000 calories a day, that works out to around two and a half cups of veggies and two cups of fruit a day. In reality, not many Americans actually manage that many servings of produce.

As a result, many people fall short on the vitamins and minerals they need for good health. This is especially true for people who take medications on a regular basis.

Magnesium is an essential mineral that is frequently low in American diets. The best sources are green leafy vegetables, nuts, fruits such as figs or raspberries and various types of beans.

Even people who do eat fruits and vegetables still could find themselves in trouble if they must take certain pills for heartburn or high blood pressure, for example. Acid-suppressing drugs like esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) limit magnesium absorption. ACE inhibitors such as enalapril and lisinopril deplete magnesium and zinc. So do thiazide diuretics like hydrochlorothiazide (HCTZ).

Low magnesium levels have been linked to depression, diabetes, high blood pressure, heart disease and arrhythmias. Symptoms include insulin resistance, severe menstrual cramps, leg cramps, fatigue and migraine headaches.

A word about zinc: Most people don’t think about it very much. Low levels can lead to changes in the senses of taste and smell, slower wound healing, diarrhea and hair loss.

Vitamin B-12 is another critical nutrient that may be affected by medication. This vitamin is found in meat, fish, poultry, dairy products and eggs, so people following vegetarian and vegan diets may come up short. The acid-suppressing medications mentioned above also can interfere with vitamin B-12 absorption. That’s because the stomach needs acid to absorb vitamin B-12 adequately. Older people, whose stomach acid production often drops dramatically, are at risk of vitamin B-12 insufficiency.

In addition, the diabetes drug metformin can lead to inadequate vitamin B-12. More than 80 million prescriptions for metformin are dispensed annually. That doesn’t include millions more for combination diabetes drugs that include metformin, like Janumet.

Certain antibiotics, such as doxycycline, ciprofloxacin and co-trimoxazole, also can affect vitamin B-12 absorption.

Vitamin B-12 deficiency can lead to serious complications such as neuropathy, which can cause burning, tingling and numbness. Low levels also can contribute to cognitive impairment and mood disorders. People who must take such medicines should ask their doctors to monitor their vitamin B-12 levels periodically.

You can learn more about the pros and cons of nutritional supplements and the interactions of drugs and nutrients in “Fortify Your Life: Your Guide to Vitamins, Minerals, and More.” The author is Dr. Tieraona Low Dog, one of the country’s leading experts on dietary supplement and integrative medicine. It is available in paperback from www.PeoplesPharmacy.com.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. In their column, the Graedons answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com.

2018 King Features Syndicate