Wednesday, March 24, 2010

Vitamins, Minerals, and Nutrients

The following is a description of the benefits and effects of various vitamins, minerals, and related nutrients

AKA: Aeon, Afaxin, Alphalin, Aquasol A, carotene, Dispatabs, pro-vitamin A, retinol, retin A, Sust- A, vitamin A acetate, vitamin A acid, vitamin A palmitate. Beta carotene (sometimes called carotene or pro-vitamin A) is found almost exclusively in plant foods and is a precursor to vitamin A, which, after it is converted by the body, works as an antioxidant (prevents vitamin C from oxidizing). Carotenoids, of which there are over 600, are also found in plant foods, but are not as plentiful or important. Retinol is the form of vitamin A found in animal foods. Vitamin A acetate and vitamin A palmitate are synthetic forms found in fortified foods. Food Sources (vitamin A): Beef, butter, chicken, egg yolk, fish, fish liver, fish liver oils, heart, kidney, liver, milk, sea food. Food Sources (Beta-carotene): Some fruits, dark-green and orange vegetables, tomatoes. Food Sources (carotenoids): egg yolks, pink grapefruit, oranges, parsley, red palm oil, shellfish, spinach, tomatoes.

Effects: Vitamin A is essential for the skin, hair, nails, and vision; helps the immune system work better; helps fight infections and speeds up healing; shields the skin from the harmful effects of the sun's UV rays; and protects the membranes of brain cells, which have lots of fat and thus are readily damaged by free radicals. Both beta-carotene and vitamin A each have their own specific antioxidant properties. A recent study by the Salk Institute for Biological Studies indicates vitamin A may be an important factor in memory and learning. Beta-carotene appears to prevent lung cancer and tumors of the mouth and throat, and recent research has shown that it may protect against memory loss and other forms of cognitive impairment. The carotenoids lutein and zeaxan-thin, found in spinach and collard greens, may help prevent macular degeneration, one of the main causes of blindness in old people. Other carotenoids could lower the chance of heart attack in men with high blood pressure by 60 to 70 percent. Astaxan-thin, which exists in some plants, yeasts, and marine animals, has 5 to 20 times the antioxidant activity of beta-carotene. Deficiency is rare, as the liver can store enough for months or even years before it is depleted, even if none is consumed in the diet. A deficiency can result in dry skin, eyes, and mucous membranes; loss of vitamin C; impaired night vision; degeneration of tooth enamel and gums; problems with bone growth; sinus trouble; loss of smell; and increased susceptibility to infections.

Precautions: Daily doses of vitamin A higher than 25,000 IU taken over an extended period of time can result in abdominal pain, loss of appetite, blurred vision, bone pain, confusion, diarrhea, dizziness, drowsiness, fatigue, hair loss, headaches, irritabilty, joint swelling, dry cracked lips, sensitivity to light, liver enlargement, irregular menses, muscle pains, nausea, rashes, restlessness, dry rough or scaly skin, swelling over the long bones, vomiting, weight loss, and liver and eye damage (the main storage sites in the body for vitamin A). These disappear when the dosage is reduced. There are some reports that large doses of vitamin C can prevent these problems. Those with kidney disorders should consult a physician before increasing intake of vitamin C. Individual needs vary widely, and what might be a low dose for one person could be toxic to another. Beta-carotene, on the other hand, is non-toxic, as the body only converts it into vitamin A when it is needed; excessive amounts may cause a yellowing of the skin (carotenosis), which is harmless and disappears when the dosage is reduced. There are other common precautions that should be kept in mind: polyunsaturated fatty acids with carotene can work against vitamin A if antioxidants are not present; women on oral contraceptives have a decreased need for vitamin A; at least 10,000 international units (IU) of A are needed if more than 400 lU/day of vitamin E are taken; and vitamin A can interfere with the effectiveness of phenytoin. If more than 10,000 ID/day are taken, it will increase the effect of anticoagulants. Antacids, aspirin, barbituates, pollution, stress, and various prescription drugs can all take their toll on the body's supply of vitamin A. The absorption of vitamin A can be inhibited by alcohol, coffee, mineral oil, an excess of iron, a deficiency of vitamin D, calcium supplements, and the drugs cholestyramine, colestipol, and neomycin. The cholesterol-reducing drug Questran (cholestyramine) may interfere with the absorption of vitamin A to such an extent that supplementation may be needed. If taking a broad spectrum antibiotic, do not take high doses of vitamin A. And vitamin A should not be taken with the acne drug Accutane (isotretinoin). The fat substitute Olestra can interfere with the absorption of carotenoids, a situation which alarms some because the average American diet is already deficient in this important class of nutrients. Paradoxically, beta-carotene has been found to increase the death rate of smokers due to lung cancer if their levels of vitamin C are low, resulting in an increase of free radicals rather than a reduction.

Dosage: The RDA for vitamin A is 5000 lU/day; the majority of health professionals recommend 10,000 to 35,000 IU daily for maximum health. Nutritionists recommend taking more beta-carotene than vitamin A, though Dr. Stuart Berger recommends a maximum daily dosage of 17,500 lU/day. About 20 to 25 mg of zinc may be needed to help utilize vitamin A that is stored in the liver, along with adequate supplies of the B vitamins, vitamin C, vitamin D, vitamin E, calcium, choline, and phosphorus. Both vitamin A and beta-carotene are absorbed more readily if consumed with foods containing fat and any hard physical activity is avoided for four hours afterwards. Carotenoids are more effective if taken in combination—for instance, alpha and beta carotenes from carrots, spirulina (an algae), dimallela salina (a marine plant), lycopene from tomatoes, and lutein from spinach. Those with poor health habits — such as smokers —and those with specific problems that inhibit absorption of vitamin A and beta-carotene — such as those with gastrointestinal or liver diseases, gall bladder problems, or diabetes— may require a higher dosage; in the latter case, higher dosages should only be taken under the careful eye of a qualified professional. Mycelized vitamin A can be at least five times as powerful as oil-based supplements, due to its higher degree of absorption. Retin A, or vitamin A acid, is commonly used in prescription doses of 10,000 to 25,000 lU/day. VITAMIN B-l AKA: Betalin S, Betaxin, Bewon, Biamine, Thiamine.

Food Sources: Asparagus, beans, bran, broccoli, brown rice, fish, kelp, lima beans, liver, lean pork, milk, nuts, oatmeal, split peas, poultry, soybeans, sunflower seeds, fresh green vegetables, wheat germ, whole-grain cereals, yeast.

Effects: A strong antioxidant, vitamin B-l also helps in stabilizes the brain and nervous system's energy production from glucose, stabilizing the appetite, aids in the functioning of the nervous system, helps repair cell damage, helps relieve air and seasickness, and is used in the treatment of herpes zoster (shingles), alcoholism, cirrhosis, overactive thyroid, infection, absorption diseases, prolonged diarrhea, and burns. A deficiency (dosages below the minimum daily requirement of 1 mg/day) known as beriberi often results in physical and mental deterioration, manifesting itself in anxiety, neurosis, depression, loss of manual dexterity, shortness of breath, numbness in hands and feet, weakness, fatigue, sensitivity to noise, loss of appetite, vision problems, irritability, confusion, poor memory, sleep disturbances, and gastrointestinal disturbances.

Precautions: There is a wide variation in the amount individuals need; some people seem to be able to manufacture it from their intestinal bacteria, though antibiotics may disturb the natural balance of these bacteria. High doses can result in deficiencies of other B vitamins, which can be prevented by increasing the intake of other B vitamins accordingly, such as with a B-complex supplement. Overdosages can also affect thyroid and insulin production, and symptoms — though rare, and usually resulting from injections of B-l— include allergic reactions, edema, faintness, headache, herpes, hives, insomnia, irritability, severe itching, muscle tremors, nervousness, rapid pulse and heartbeat, rash, weakness, and wheezing. Antibiotics, oral contraceptives, chronic heavy drinking, antacids, barbituates, caffeine, carbonated citrates in food and drinks, estrogen, fever, stress, sulfa drugs, tobacco, and eating fish, clams, eggs, brussel sprouts, and red cabbage in their raw state can destroy or inhibit the absorption of B-l. Cooking, food processing, and marinating meat in soy sauce, vinegar, or wine can also contribute to the destruction of this vitamin in foods. Vitamin B-l should be taken with carbohydrates, as it helps metabolize them, though a diet too high in carbohydrates may increase the need for B-1. Its benefits are enhanced when taken with adequate amounts of other B vitamins, vitamins C and E, manganese, and sulphur. It may enhance the effects of neuromuscular blocking agents, a class of drugs used with anesthesia to relax the muscles during surgery. It should not be taken in high doses in combination with vitamin C and the amino acid L-cysteine except under the supervision of a doctor, as these can render insulin inactive. High doses can produce false positive results in tests for uric acid and urobilinogeh; it can also produce a false reading in a test for the level of theophylline (a drug used for the treatment of bronchial asthma) in the blood.

Dosage: The RDA is 1.4 mg/day for men, 1 mg/day for women. Recommended dosage is 50 to 1000 mg/day, though 100 to 300 mg/day is probably the optimal range. It is best taken with the other B vitamins, including pantothenic acid, folic acid, B-12, and the equivalent amounts of B-2 and B-6. Should be taken in 3 or 4 divided doses with meals.

AKA: Niacin, niacinamide, nicotinic acid, nicotinamide. L-tryptophan can be converted by the body into B-3, though it takes 60 parts tryptophan to make one part niacin, and a person who is deficient in B-l, B-2, and B-6 may not be able to produce niacin in this manner.

Food Sources: Avocados, brewer's yeast, dates, eggs, figs, fish, lima beans, liver, lean meat, milk, roasted peanuts, poultry (white meat), prunes, wheat germ, whole wheat products.

Effects: Improves memory and other mental functions, protects against stress, reduces blood clotting, and improves the oxygen-carrying ability of red blood cells. Drs. Humphry Osmond and Abram Hoffer contend that B-3 is an effective treatment for schizophrenia, though other researchers have not been able to duplicate their success. Vitamin B-3 is a histamine releaser, which can cause a flushing, tingling, and redness of the skin in some people, effects which can heighten sexual pleasure. It is also necessary for the synthesis of cortisone, throxine, and insulin, as well as the sex hormones estrogen, progesterone, and testosterone. The vitamin can relieve gastrointestinal problems, maintain the health of the skin, ease the severity of (or even prevent) migraines, fight canker sores and bad breath, and lower cholesterol and triglyceride levels. It is used to treat vertigo, ringing in the ears, premenstrual headaches, reduced levels of cholesterol and triglycerides in the blood, and pellegra. The active coenzymatic form, and a natural metabolite, of B-3, called variously niacinamide adenine dinucleotide, nicotinamide adenine dinucleotide, NAD, or NADH (the reduced form), has shown promise in mental enhancement, though only recently has a process been developed that can stabilize this nutrient so that it can be taken orally, and one admittedly flawed study using 17 subjects suggests that 5 mg twice daily can improve the symptoms of Alzheimer's. Much more research is needed. A deficiency is known as pellegra, and is characterized by gastrointestinal disturbances leading to a redness of the skin and inflammation, inability to recall recent events, apprehension, depression, emotional instability, and hyperirritability. An unusual sensitivity of the skin to sunlight may be an early warning sign. The victims of pellegra suffer from dermatitis, diarrhea, dementia, and some cases lead even to death.

Precautions: It should not be taken by those sensitive to niacin or who have liver disease, stomach ulcers, very low blood pressure, gout, or hemorrhaging. It should be taken only under the guidance of a physician if any of the following conditions are present: diabetes, gall bladder or liver disease, glaucoma, gout, high blood pressure, impaired liver function, porphyria, sensitivity to tartrazine dye, or ulcers. Those with ulcers may have to take an antacid to prevent aggravating their condition, and those with gout may find their symptoms increasing because of increased uric acid levels in the blood. Individuals with allergies may have problems, as nicotinic acid reportedly raises the histamine level in the body. Some may also find that they have an abnormal glucose tolerance such as found in diabetics. In some cases, extremely high doses — over 750 mg/day — can cause abdominal cramps, diarrhea, fainting, body flush, jaundice, lightheadedness, liver damage, nausea, sweating, vomiting, weakness, and "niacin hepatitis," though the latter is not life-threatening. In doses larger than 50 mg (the RDA is 18 mg/day for men, 13 mg/day for women), it may cause dry skin, a flushing or redness of the skin accompanied by a tingling, dizziness, itching, or headaches for about 10 to 20 minutes when first starting supplementation; the flushing usually occurs on an empty stomach, is reportedly harmless, and should go away within two months. Some say this only occurs with pure niacin, and that taking aspirin an hour before taking B-3 or drinking a glass of water with the vitamin can prevent these symptoms, while others say that this only occurs with nicotinic acid. It should be noted that there is good evidence that toxicity can result from long-term intake of as low as two and one-half times the RDA. There are time-release niacin tablets that avoid the flush, but some evidence indicates that the continuous release of niacin may be detrimental to the liver. Other uncommon side effects may include abdominal pain, bloating, low blood pressure, diarrhea, fainting, gas, rapid or irregular heartbeat, heartburn, and hunger pains. Even rarer are incidents of nervousness and panic caused by high doses of nicotinic acid, blurred vision and related eye problems, and apparently one case of hypothyroidism. "Nicotinic analogues" or "niacin analogues" are drugs used to treat specific conditions, and have no value as vitamin supplements. Similarly, niacinimide, which avoids the niacin flush, lacks many of the beneficial effects of niacin, and can also cause liver damage and, in some people, depression. Nicotinic acid can also interact with ganglionic blocking drugs, enhancing their blood pressurelowering effect. Isoniazid, used to treat tuberculosis, can increase the need for niacin. Nicotinic acid can also interfere with the Benedict's reagent test for sugar in the urine, the measurement of catecholamines in the blood or urine, and — in one case — it has decreased the liver's uptake of the chemical used to make that organ visible for a liver scan. Niacin can reduce the effectiveness of antidiabetic drugs, probenecid, and sulfinpyrazone. Combining with betaandrenergic blocking agents, mecamylamine, methyldopa, or alcohol could result in excessively low blood pressure. Combining with HMG-CoA reductase inhibitors could increase the risk of heart or kidney problems. With cocaine, it could cause an increased flushing of the skin. Niacin can be destroyed by alcohol, antacids, aspirin, estrogen, food processing, sleeping pills, sulfa drugs, and water. Its effectiveness can be reduced by tobacco and obesity.

Dosage: Start at low doses and gradually increase to 100 to 200 mg/day. It should be taken in 3 to 4 divided doses, preferably with meals. A highprotein diet with meat, eggs, enriched cereals, and other foods high in B-3 can provide adequate amounts.

AKA: Calcium pantothenate, Dexol T.D., pantothenic acid, panthenol.

Food Sources: Avocados, broccoli, chicken, egg yolks, lentils, liver and other organ meats, nuts, oats, fresh vegetables, and yeast are the best sources. Vitamin B-5 occurs in such a wide variety of foods that a deficiency is rare and, if it does occur, indicates a diet so poor that deficiency symptoms of other vitamins are also likely to be present.

Effects: A strong antioxidant, stamina enhancer, and protector against stress. It helps in the synthesis of acetylcholine, is essential for the synthesis of antibodies, and is needed for the utilization of PABA and choline. Among the other benefits are the healing of wounds and minimizing the side effects of many antibiotics. According to Earl Mindell, 1000 mg twice a day with meals helps relieve the suffering from allergies. It may help promote sleep when combined with inositol. A naturally occurring deficiency is probably extremely rare, and is characterized by blood and skin disorders, duodenal ulcers, and hypoglycemia.

Precautions: It can cause heartburn or, less frequently, cramps. Rare symptoms include hives, rash, and difficult breathing. There are no known overdose symptoms, though initial large doses can cause temporary diarrhea. Taken by itself over an extended period of time may increase the need for B-l, leading to neuritis. There is no known toxicity. It should not be taken by those who are allergic to pantothenic acid, and those with hemophilia should consult a physician first. Vitamin B-5 can be destroyed by alcohol, caffeine, canning, cooking, estrogen, food processing, heat, sleeping pills, sulfa drugs, and tobacco. It can reduce the effectiveness of levodopa (but not carbidopalevodopa). Chloram-phenicol, cycloserine, ethionamide, hydralazine, immunosuppressants, isoniazid, and penicillamine can all reduce the absorption of B-5 and cause anemia and tingling or numbness in the hands and feet.

Dosage: It is generally recommended that initial doses should be 100 mg/day, gradually increasing to 250 to 1000 mg/day in 3 to 4 divided doses.

AKA: Beesix, Hexa-Betalin, Pyridoxine, Pyroxine, Rodex, Vitabec 6. Vitamin B-6 is actually a trio of very similar substances — pyridoxine, pyridoxinal, and pyridoxamine — working together. Though it is a water-soluble vitamin that needs to be supplied every day, there is some evidence that it can be manufactured by intestinal bacteria, possibly by the cellulose in a largely vegetarian diet.

Food Sources: Bananas, beef, blackstrap molasses, bran, brewer's yeast, brown rice, cabbage, cantaloupe, carrots, diary products, eggs, fish, grapes, kidney, lamb, liver, meat, milk, nuts, peas, pork, potatoes, poultry, prunes, wheat bran, wheat germ, whole grains.

Effects: Vitamin B-6 protects against stress and is needed by the brain for transporting and metabolizing amino acids to develop various neurotransmitters (such as norepinephrine, serotonin, and dopamine) needed for mental energy and memory. The vitamin also helps the immune system by producing antibodies and red blood cells. Necessary for the proper functioning of the thymus, spleen, and sexual organs. Those on a high-protein diet will need more B-6. It may play a key role in fat metabolism, so a diet rich in animal fats may be more likely to result in cholesterol plaques if there is insufficient B-6. Diabetics may find that B-6 can be used to decrease their need for insulin, though experimenting with supplements could be risky. It may also help in relieving the symptoms of depression and sickle-cell anemia. Research has shown that women can cut their risk of heart disease in half by consuming at least 400 meg/day of folic acid and 3 mg/day of B-6; it is believed men can enjoy similar benefits from such an increase. A deficiency can be similar to thiamin and niacin deficiencies, resulting in acne, anemia, arthritis, brain-wave abnormalities, convulsions, depression, glossitis, hair loss, headaches, inflammation of the mouth and tongue, irritability, learning disabilities, mental confusion, nausea, malfunctioning of the nervous system, nervousness, seborrheic dermatitis, and possible cardiovascular disease. A deficiency of both B-6 and folic acid is correlated with a high level of the amino acid homocysteine, which plays a role in heart disease.

Precautions: Too much B-6 in the body can result in night restlessness and very vivid dream recall. Taking more than 200 mg/day can cause peripheral neuropathy and such high dosages should be administered only under the guidance of a physician. Doses higher than 500 mg/day may be toxic, leading to serious central nervous system problems, with such symptoms as pain in the arms and legs, a numbness or tingling in the hands and feet, clumsiness, loss of balance, and difficulty in walking. Chronic megadoses of 2 to 6 grams/day used to treat carpal tunnel syndrome have led to vitamin toxicity and sensory neuropathy, which go away once the dosage is reduced, though some permanent nerve damage (such as loss of sense of touch) may remain. High doses of B-6 can lead to increased susceptibility to cadmium toxicity. High protein diets increase the need for B-6. Vitamin B-6 can be destroyed by alcohol, birth control pills, canning, estrogen, food processing (up to half the B-6 in flour may be lost in the refining process), roasting or stewing of meat, radiation, and tobacco. The following drugs may increase the need for B-6: birth control pills, chloramphenicol, cycloserine (Seromycin), estrogens, ethionamide, the ingredient Hydralazine (contained in such blood pressure medications as Apresazide, Apresoline, Rezide, Ser-Ap-Es, Serpasil-Apresoline, and Unipres), Isoniazid, and Penicillamine (a drug unrelated to penicillin which is used to treat rheumatoid arthritis and rare genetic diseases), and immuno-suppressants. The vitamin can interfere with the effects of hypnotic barbiturates, L-dopa (though the drug Sinemet may be able to bypass this interaction, and a carbidopa-levodopa combination does not have this problem), phenobarbital, and phenytoin.

Dosage: Some suggest 10 to 75 mg/day; others, 50 to 200 mg/day in 3 to 4 divided doses. Do not exceed 500 mg/day. Best taken with vitamins B-l, B-2, pantothenic acid, C, and magnesium.

AKA: Acti-B-12, Alphamin, Alpha Redisol, Anocobin, Bedoc, Berubigen, Betalin 12, Cobalamin, Codroxomin, Cyanabin, cyanocobalamin, Droxomin, hydroxocobalamin, Kaybovite, Kaybo-vite- 1000, Redisol, Rubion, Rubramin, Rubramin-PC. The only B vitamin that can be stored by the body (the liver can store three to five years worth).

Food Sources: Beef, brewer's yeast, cheese, dairy products, egg yolk, fish, kidney, liver, milk, pork, seaweed, soybeans and soy products, yeast, yogurt.

Effects: Encourages RNA and DNA synthesis in nerve cells, is needed for the transportation and storage of folic acid, helps stabilize the brain's metabolism of carbohydrates and proteins and its synthesis of myelin in the nerves, plays an indirect role in making choline available for the synthesis of neurotransmitters, protects against stress and fatigue (promotes the release of energy in foods), and is an essential growth factor needed for healthy brain and nerve function. Lab rats experience an increase in their rate of learning, and it has been used to treat depression, insomnia, and memory loss. Preliminary studies have shown that supplementation of B-12 and folic acid may prevent or delay the onset of Alzheimer's. According to Pearson and Shaw, a dose of approximately 1000 micrograms taken immediately before sleep has about a 50% chance of creating dreams in color. Combined with folic acid and methionine, it can help manufacture choline in the body. Because the body can recycle the vitamin, deficiency is rare, and years of chronic inadequate intake may precede the onset of symptoms. Those at risk include smokers, heavy drinkers, pregnant women, vegans, those who do not produce enough intrinsic factor in the stomach to help utilize it, those with chronic malabsorption problems, those who have undergone stomach surgery, and those taking estrogen, potassium supplements, sleeping pills, and anticoagulant drugs. A deficiency is known as pernicious anemia, and symptoms include poor appetite, a tingling in the hands and feet, depression, nervousness, nerve disorders, fatigue, weakness, digestive disorders, memory loss, moodiness, difficulty walking and maintaining balance. The effects of pernicious anemia may include nerve transmission problems, severe psychosis, brain damage, and death. Deficiency symptoms of B-12 can be masked by taking more than 1000 meg/day of folic acid.

Precautions: It should not be taken by those with Leber's disease (optic nerve atrophy). Those with gout should consult a physician before taking supplements. The RDA for adults is 3 micrograms, yet no toxicity was observed in tests where individuals took 500 to 1000 micrograms (0.5 to 1 mg) for up to five years, or took 100,000 micrograms in a single dose. Allergies to this vitamin are rare, and reactions (the symptoms for which include acne, eczema, and a swelling or crusting of skin around the lips) usually occur with injections, rather than tablets. Rare side effects consist of itchy skin, wheezing, and diarrhea. Life-threatening symptoms, usually resulting from overdose, consist of faintness (from anaphylaxis), hives, itching, and rash. Dilantin can deplete the body's stores of B-12, and an underactive thyroid gland can interfere with the absorption of this vitamin. It can also be destroyed or have absorption interfered with by acids and alkalies, alcohol, anticonvulsants, chloramphenicol, cholestyramine, cimetidine, coffee, colchicine, estrogen, famotidine, laxatives, neomycin, nizatidine, oral contraceptives, potassium (extendedrelease forms), ranitidine, sleeping pills, stomach medications (such as Prevacid, Prilosec, Pepcid, Tagamet, and Zantac), sunlight, tobacco, vitamin C (if taken within two hours of each other), and water. As it is only found in meat and dairy products, strict vegetarians may not get enough, though lack of deficiency in nonmeat eaters leads some to speculate that some vegetables may contain bacteria that produce B-12. The vitamin needs to be taken with calcium to be properly absorbed and utilized by the body.

Dosage: 3 meg/day. It is absorbed best when taken with meals that contain calcium. It is recommended that those age 51 and over take 4 meg/day; however, recent evidence suggests that some older people who have less stomach acid and more digestive bacteria may need to take as much as 25 meg/day. Some tablets sold contain the B-12 intrinsic factor, a mucoprotein secreted in the stomach which aids in the absorption of this vitamin, overcoming deficiency. Vitamin B-12 injections are generally regarded as worthless.

AKA: Calcium pangamate and pangamic acid.

Effects: Prevents oxygen deprivation in the body's tissues, while reducing oxidation within cells. The active ingredient is dimethylglycine (DMG), a metabolic brain enhancer said to detoxify the body, lower cholesterol, and protect the liver. Its advocates contend that DMG increases energy, endurance, and strength (mainly by reducing the lactic acid in the muscles), improves the immune system (mainly be creating phosphocreatine, which also helps the muscles contract), and maximizes blood transport from the blood to the heart and brain.

Precautions: Though it is nontoxic, sale of B-15 is illegal. It is not a vitamin, as there is no evidence that the body has a need for it. None of the benefits claimed for it or DMG have any basis in fact. In fact, there is evidence that DMG and another component, diisopropylamine-dichloracetate (DIPADCA), are potential carcinogens.

Dosage: Approximately 150 to 250 mg/day, according to John Mann. Sheldon Saul Hendler, M.D., Ph.D., does not recommend supplementation under any circumstances.

Food sources: Most fruits and vegetables, particularly dried fruits.

Effects: Boron helps keep the brain alert and able to perform simple functions. It also helps keep the bones strong and metabolizes calcium, magnesium, and phosphorus. Deficiency is rare.

Precautions: While there appear to be no adverse effects with doses as high as 6 mg/day, dosage should not exceed 10 mg/day.

Dosage: There is no RDA. The recommended dose is 3 mg/day. It is best if taken with a multivitamin which includes calcium, magnesium, manganese, and riboflavin.

AKA (Vitamin C): Ascorbic acid, Ascorbicap, ascorbyl palmitate, calcium ascorbate, Cecon, Cemill, Cenolate, Cetane, Cevalin, Cevi-Bid, Ce-Vi-Sol, Cevita, cevitamin acid, C-Span, Ester C, Flavorcee, magnesium ascorbate, Re-doxon, sodium ascorbate, Sunkist. AKA (Bioflavonoids): Flavonoids, vitamin P. Man is the only animal that cannot synthesize vitamin C in the body (apes and guinea pigs have a similar problem in that their bodies cannot synthesize it fast enough), though some research indicates that human placentas and nursing mothers may have this ability. There are two new forms of vitamin C. One, Ester C, has a higher level of bioavailability —patients given this form of the vitamin only need 20 to 30 percent of the usual dose of vitamin C, as it enters the body tissues faster and remains there longer than regular vitamin C. The other, ascorbyl palmitate, is a fat-soluble form (vitamin C is basically water-soluble): it remains in the fat tissues until used by the body and is not wasted through excretion. The dosage is about 250 mg/day. Bioflavonoids, which include rutin and hesperidin, are part of the C complex of vitamins, and work synergistically with C. They give plants their color, and researchers have identified over 500 of them.

Food Sources: Bean sprouts, berries, cauliflower, citrus fruits, liver, potatoes, sweet potatoes, tomatoes, green leafy vegetables.

Effects: Works as an antioxidant (unlike antioxidants vitamin E, beta-carotene, and CoEnzyme Q10, which reduce oxidation damage, vitamin C works preemptively, intercepting the oxidants that initiate the free-radical cycle) is needed for the manufacture of neurotransmitters and cell structures, helps preserve the elasticity of the skin and capillaries, protects the lungs by preventing oxygen from converting into peroxides, boosts the immune system, helps wounds heal faster, helps the intestine absorb iron, lowers blood cholesterol, protects the body against the effects of pollutants (particularly the metals lead, mercury, and aluminum) and chemical toxins (such as formaldehyde, organic solvents, and pesticides), protects against bacteria and viruses, protects against heart and blood diseases, protects against heart attacks, reduces anxiety, and aids in restful sleep. Additionally, vitamin C, a natural antihistamine, increases alertness and mental functioning, may help safeguard against and reduce the symptoms of colds and flu, helps build collagen (the connective tissue in the body), and diminishes the duration and severity of herpes blister outbreaks. It also helps regenerate vitamin E after the latter has done its own job of eliminating free radicals. With vitamin E, it can counteract the effects of a fatty meal, especially damage done to blood vessels from high cholesterol. According to some studies, students with high vitamin C levels did better on IQ tests than those with lower levels. A deficiency is known as scurvy which, though rare, may be the end result of long-term deprivation of vitamin C. Symptoms include bleeding gums, hemorrhaging, loose teeth, emotional disturbances, and poor healing of wounds. Some contend that the U.S. RDA of 60 mg/day prevents these obvious symptoms, but does not prevent the occurrence of subclinical deficiency, a slight deficiency which may have no readily identifiable symptoms and which may lead to health problems years down the line. The only deficiency symptom of bioflavonoids that has been identified is bleeding gums.

Precautions: Supplements should not be taken by those with increased iron absorption (caused by such conditions as hemochromatosis), diabetes, folk acid deficiency (from such conditions as alcoholism), serious kidney disease or kidney failure, leukemia, polycythemia (an increase in the blood's total cell mass), thalassemia (hereditary anemia), thrombosis, or an allergy to vitamin C. It can also cause problems in people with sickle cell anemia, G-6PD deficiency, kidney stones, or gout. Some brands contain tartrazine dye, and should be avoided by those who are allergic. With too high a dose, diarrhea, dizziness, gastritis, gas, headaches, light-headedness, nausea, and vomiting can occur, though these may be just temporary. Rare symptoms include abdominal pain and anemia. Lowering the dosage or using a buffered form (such as sodium ascorbate, calcium ascorbate, and Ester C) can stop these symptoms. In fact, the first sign of diarrhea (called the "bowel tolerance") is a sign that the body's optimal dosage of vitamin C has been surpassed. Daily dosages above 500 mg/day may deplete the level of copper in the blood of males, leading to anemia; whether this also occurs in females is unknown. Vitamin C may also deplete the sulfur reserves in the body, placing vegetarians at risk, as this mineral is mainly found in eggs. Women taking 2000 mg or more a day may experience fertility problems; individuals taking 2000 mg or more a day may lower the resistance of their white blood cells to fight one common form of bacteria, and may need to take a folic acid supplement, as such a high dose of C will deplete this B vitamin. Those taking 3000 mg or more a day may experience reduced levels of the amino acid cysteine in the blood (though this condition is not serious) and lowered resistance to high altitude conditions. Dosages above 4000 mg/day can increase kidney stone formation in those already susceptible (though magnesium supplements may prevent this problem). Deficiency symptoms related to scurvy that accompany a sudden withdrawal of high dosages are rare. Vitamin C should not be taken in large doses in conjunction with vitamins B-l and the amino acid Lcysteine, as they can render insulin ineffective. In doses above 200 mg/day, vitamin C by itself may reduce the effectiveness of warfarin and other oral anticoagulants, dicoumarol, amphetamines, anticholinergics, mexiletine, quinidine, tranquilizers such as phenotiazine, and a class of drugs called tricyclic antidepressants, including Amitriptyline (also known as Elavil, Endep, Etrafron, Limbitrol, Triavil), Amoxapine (also known as Asendin), Desipramine (also known as Norpramin, Pertofrane), Doxepin (also known as Adapin, Sinequan), Imipramine (also known as Tofranil), Nortriptyline (also known as Aventyl, Pamelor), Protriptyline (also known as Vivactil), Trimipramine (also known as Surmontil). It can also slow down the metabolizing of aspirin by the body, which can lead to a toxic buildup after several doses. Vitamin C can increase the effect of barbiturates, increase the iron absorption from iron supplements, increase the side effects from estrogens (if vitamin C taken is more than 1 g/day), and lead to salicylate toxicity if such supplements are taken. Drugs whose long-term use may increase the need for vitamin C include barbiturates, birth control pills, cellulose sodium phosphate, cortisones, levodopa, phenacetin, salicylates, sulfonamides, and tetracycline. More than eight aspirin a day for more than a week can cause the body to excrete more vitamin C; even a few can cause the body to excrete it at up to three times the normal rate. Vitamin C can give false readings for the following blood and urine lab tests: blood bilirubin, blood glucose, creatinine, LDH, occult blood test for colon cancer, SCOT, uric acid, and urinary glucose. Chewable vitamin C can lead to severe dental erosion. Extra care should be taken when using the powdered form, mixing it fresh each time, as C will readily oxidise to the toxic form dehydroascorbate. Those who experience stomach problems or heartburn from taking ascorbic acid may eliminate these problems by taking calcium ascorbate, magnesium ascorbate, or sodium ascorbate. Contrary to earlier beliefs, large doses of C does not destroy B-12 (if taken more than two hours apart) or contribute to the formation of kidney stones in those not already susceptible. Alcohol, antibiotics, aspirin, baking soda, cooking, copper pots, cortisone, heat, high fever, light, oxygen, smoking (each cigarette can destroy 25 to 100 mg), stress, vitamin A deficiency, and water can all contribute to the loss or reduced effectiveness of this vitamin. Vegetables should be washed, but not soaked, to prevent vitamin loss, and fruits and vegetables should be cut with a sharp knife immediately before consumption, as bruising with a dull knife and letting cut food stand can destroy vitamin C. Fresh fruits and vegetables should be eaten within a few days, and frozen vegetables should not be thawed before cooking. There should be at least a three-hour span between taking vitamin C and taking ginseng, as some of the ginseng may be neutralized.

Dosage: The current RDA is 60 mg/day, though a 1999 research paper in the Journal of the American Medical Association recommends that this be increased to 200 mg/day. Some recommend 1000 to 3000 mg/day, others 2000 to 5000 mg/day, in 3 or 4 divided doses. It has often been taken in doses up to 10,000 mg/day without serious consequences; it encourages the production of other enzymes that utilize C and is water-soluble, so it is readily excreted by the body. Smart drug expert Michael Hutchison even states that dosages of 10 to 20 grams are not unheard of! In fact, one would probably have to ingest several pounds a day to reach toxic levels. It is more effectively utilized by the body if taken with bioflavonoids, plus the minerals calcium and magnesium. Earl Mindell recommends 100 mg of bioflavonoids for every 500 mg of C, with the ideal balance of ten parts bioflavonoids to one part rutin and hesperidin. Dr. Stuart Berger states that bioflavonoids, or the so-called vitamin P, is not a vitamin at all, but a growth factor needed by certain organisms, excluding man. Moreover, Sheldon Saul Hendler, M.D., Ph.D., states that there is no solid evidence that bioflavonoids help the body utilize vitamin C better; in fact, one study shows that synthetic vitamin C is absorbed more fully than "natural" vitamin C from orange juice or vitamin C with rutin.

Food Sources: Beef, beer, black pepper, bran, brewer's yeast, cheese, chicken, clams, corn oil, liver, meat, mushrooms, poultry, shellfish, thyme, wheat germ, whole-grain cereals.

Effects: Chromium assists in the breakdown and distribution of proteins and carbohydrates in the body. It is also essential for the production of an enzyme-like substance called Glucose Tolerance Factor or GTF (chromium combined with nicotinic acid and amino acids), which aids in the making and proper utilization of insulin; this insulin, in turn, takes carbohydrates from the blood and gets them to the brain cells, which use them for energy. It is believed that sufficient amounts keep the blood sugar on a consistent level, preventing mood swings, depression, and adultonset diabetes, and providing energy throughout the day. Chromium picolinate is a scientifically developed form which appears to be more efficient than regular chromium; it may also have a mild muscle-building effect on people with a regular exercise program. Chromium picolinate, as well as chromium polynicotinate and chromium chloride, can inhibit sugar-induced high blood pressure. The picolinate and polynicotinate forms (the latter sold under the brand name Chrome-Mate) also act as antioxidants. Deficiency (which may be very widespread in the U.S. population) can lead to diabetes mellitus (though this condition may result from a chromiumpoor diet that is deficient in other minerals, too) and arteriosclerosis (though chromium's exact role in this is not yet clear). Refined sugar should be avoided for three reasons: it has been stripped of its chromium (along with the magnesium), it requires chromium to metabolize it, and it causes a loss of chromium through the urine.

Precautions: Some people cannot convert chromium chloride or chromium from chelated supplements into the "biologically active" form, or GTF, that the body can use, in which case chromium should only be taken under a doctor's supervision, especially in cases of those who are diabetic. Chromium salts, which are an inorganic form of chromium, do not seem to be absorbed by the body very well and so are of little use as supplements. As people get older, they retain less of this mineral in their bodies. A few more things should be kept in mind: cases of allergies to this mineral have been reported; and the chromium content of brewer's yeast, though often high, varies among brands. There are no known symptoms of toxicity, attributable, perhaps, to the low absorption rate (about 2 percent of intake); however, ulceration of the nasal tissues and toxic levels can occur with long-time exposure in workers who deal with chromium in metal plating or making dyes. There is one case of a false-positive reading for a test of porphyria in a man who took one-third of an ounce a day. Chromium supplements should not be taken at the same time as vanadium supplements, as there could be a negative interaction between them. Chromium picolinate's reputation as a muscle-building nutrient may be overrated, its effect possibly due to the fact that subjects may have been deficient in chromium to begin with. One study in 1996 showed that chromium picolinate caused chromosome damage in cells that had been grown in a laboratory; what this means for individuals taking the supplement is, as yet, undetermined.

Dosage: The RDA has not yet been established. Studies seem to indicate that 200 meg/day for women is a good dose; athletes and those who exercise heavily — male or female — may need up to 400 meg/day (though Dr. Stuart Berger recommends only 40 meg/day for those who exercise at least 5 times a week). Some recommend no more than 200 meg/day on the basis that no adequate research has been conducted on levels higher than that. Studies on lab animals have shown, however, that it might take a dose of several thousand times the recommended dosage to produce adverse side effects.

AKA: Acumen, Atrol, Bimanol, Cervoxan, dimethylaminoethanol pace-tamidobenzoate, Deaner, deanol, Difo-rene, Dimethaen, Dimethylaminoethanol, DMAE-H3, Elevan, Pabenol, Paxanol, Risatarun, Tonibral, Varesal.

Food Sources: DMAE exists in tiny amounts in the brain and is found in such seafoods as anchovies, herring, and sardines. The prescription drug Deaner (deanol) is chemically similar.

Effects: When combined with phosphatidyl choline and vitamin B-5, it produces acetylcholine, the neurotransmitter essential for short-term memory. It also removes the cellular aging pigment called lipofuscin, a waste product that may inhibit nerve cell functioning. There is some evidence it stabilizes the cell membranes of neurons, preventing one of the major factors of aging, the breakdown of neuronal membranes. It is similar in effect to centrophenoxine or Lucidril, in that it elevates mood, strengthens memory and learning, improves intelligence, lengthens the life span of lab animals (in one study, it lengthened the life span of mice 33-50 percent), reduces fatigue, produces sounder sleep, and decreases the amount of sleep needed. It can cross the blood/ brain barrier more readily than choline or lecithin, so an effective dosage is much lower than for the other two supplements, and it has a mild, steady stimulant effect which is said to lead to no letdown or side effects. No letdown or depression is experienced if use is discontinued. Works synergistically with choline, Hydergine, Piracetam, Selegiline, and vasopressin, so lower doses should be taken if any of these supplements are also being taken.

Precautions: People with manic-depression should not take DMAE, as it can worsen the depressive phase; those with epilepsy or seizure disorders should only do so under a physician's guidance. Too high a dosage (at least 500 mg/day in some cases) can cause anxiety, nervousness, increased blood pressure, insomnia, dull headaches, or muscle tension (especially in the jaw, neck, and legs), which disappear if dosage is reduced. There are no known serious side effects or contraindications.

Dosage: Gradually increase the dosage until it is around 500 to 1000 mg/day, though many people may respond well to lower dosages; one study recommends oral doses as low as 10 to 30 mg/day, which is enough to produce the desired effects. In general, older people can tolerate higher doses, either because they have lower levels of acetyl-choline, they may have reduced receptor sensitivity to acetylcholine, or they may have altered feedback in their brain metabolism. It may take up to three weeks before the effects are noticed. It should be stored in a cool, dark place, as it can deteriorate rapidly.

AKA: Aquasol E, Chew-E, d-alpha-tocopherol, d-alpha-tocopheryl acid succinate, dl-alphatocopherol, dl-alpha-tocopheryl, Eprolin, Epsilan-M, Pheryl-E, Viterra E. Eight different forms of vitamin E molecules, or vitamers, are found in nature (alpha, beta, gamma, delta, epsilon, zeta, eta, and theta), each of which is absorbed differently in the body and stays in the body for varying amounts of time. As yet, there is no evidence that each of these forms serves a specific purpose. Even so, some recommend switching back and forth between these mixed tocopherols and D-alpha-tocopherol, both in their natural forms. Controversy has arisen over the efficacy of natural versus synthetic forms of vitamin E. While most synthetic vitamins are just as effective as the natural forms, such is not the case with E. Vitamin E exists in two forms, each a mirror image of the other, the dtocopherol (right-handed) form and 1- tocopherol (left-handed) form. Only the "d" forms are produced in nature, while the synthetic products are a mixture of both "d" and "1" forms, therefore d-alpha-tocopherol would be a natural vitamin whereas d-alpha-tocopherol would be synthetic. Synthetics are only 50 to 70 percent as effective as naturals. Still, synthetic and natural are equally as effective in preventing heart disease and inhibiting the oxidation of LDL cholesterol. According to one study, doses of 400 to 800 ID/day can reduce heart attacks by 77 percent in those already suffering from heart disease. Though vitamin E is fat-soluble, it acts more like a water-soluble vitamin, as it is excreted by the body rather quickly.

Food Sources: Eggs, nuts and oils of nuts, seeds, soybeans, soybean oils (cold-pressed and unrefined only), fresh wheat germ, wheat germ oil, whole grains; smaller amounts are found in asparagus, broccoli, brussel sprouts, cabbage and other dark leafy vegetables, molasses, and sweet potatoes.

Effects: Vitamin E is a strong antioxidant, especially when taken in conjunction with selenium. It also strengthens the immune system; enhances the ability of brain cells to use oxygen; increases the ability of cells to make energy; helps preserve the lung function of elderly people; and it may slow the aging process by protecting the skin and brain cells (which have high percentages of fat compared to the rest of the body's cells) from free radicals (as people age, their ability to absorb E decreases). It has been used by NASA astronauts to fight the breakdown of red blood cells from radiation. In the past few decades in the U.S., there seems to be a direct correlation between the decline in the amount of vitamin E in the diet and the rise in heart attacks, but hard evidence is still lacking. Recent evidence indicates that an optimum level of 200 lU/day can protect the elderly from heart disease and dementia, as well as boost the immune system; higher doses have not led to greater protection. When given in doses of 2000 lU/day, it may slow the progress of Alzheimer's to a moderate degree, though it is still not known whether it can protect healthy people from getting the disease. A dosage of as little as 50 lU/day, or five times the minimum daily recommended intake for men, can help protect against lung, colorectal, and — especially —prostate cancers. Regular supplementation has also been proven to protect against exercise-induced DNA damage that may lead to cancer. In lab rats, it has been shown to prevent liver damage and liver cancer caused by DHEA. It also helps the body utilize vitamin A better, and raises the levels of HDLs, the "good" cholesterol. It is reported to extend the life of red blood cells, dilate the blood vessels, and thin the blood. It can even halt, and sometimes reverse, nerve damage caused by such neurological disorders as cystic fibrosis and chronic liver disease. Vitamin E breaks down sodium nitrate, a food additive and suspected carcinogen; blocks the formation of nitrosamine, another carcinogen; prevents lung damage from nitrogen oxides; and can counteract the effects of a fatty meal, especially damage done to blood vessels from high cholesterol. Works synergistically with the steroid DHEA. Deficiency symptoms include gastrointestinal problems, dry dull hair, heart disease, impotency, miscarriages, enlarged prostate, and sterility.

Precautions: No known toxicity up to 3200 IU, though it should not be taken by those who are allergic to vitamin E. Those with thrombophlebitis (blood clots in the leg veins) or liver disease should consult a physician first. Evidence indicates that it may suppress the immune system when taken in doses of 100 IU or more. It can elevate blood pressure when first taken, so those with high blood pressure or heart disease should not take more than 200 IU without consulting a physician first. Dosages above 600 lU/day should not be taken by those with high blood triglyceride levels or a thyroid condition. Vitamin E prolongs the clotting of blood, which can lead to problems such as bleeding-type strokes, cerebral hemorrhage, internal bleeding or ecchymoses (discoloration of the skin due to blood leaching into body tissues) if there is a deficiency of vitamin K, certain rare medical conditions are present, or if a person is taking coumarin-type drugs or drugs with anticlotting properties, such as Warfarin (Coumadin) or aspirin. Vitamin E supplementation should be stopped about two weeks before surgery, as it could cause excessive bleeding. Paradoxically, vitamin E may cause blood clots if taken in doses above 800 lU/day. Common side effects include breast enlargement, dizziness, and headaches. It may also cause abdominal pain, diarrhea, fever, gas, hives, chapped lips, muscle aches, nausea, upset stomach, fatigue, weakness, and blurred vision, though these are rare. Allergies can also occur when vitamin E is used in skin preparations, but these are extremely rare. Overdose symptoms consist of fatigue, nausea, and vomiting. Lab animals given extremely high doses have experienced adverse effects on their adrenal, thyroid, and sex glands. Recent evidence indicates that the pill form may be harmful, as most only contain alpha-tocopherol, and may do an incomplete job of neutralizing some harmful compounds. Only gamma-tocopherol can eliminate peroxynitrite, a very destructive nitric oxide radical found at sites of inflammation which can lead to cancer and heart disease, and remove nitrogen oxide, a component of air pollution. High levels of alpha-tocopherol can suppress levels of gamma-tocopherol in the blood. Unfortunately, it is impossible to maintain adequate levels, even from a healthy diet; some, however, say a healthy diet can offset this deficiency. Vitamin E can increase the effect of oral anticoagulants, decrease the effect of iron supplements in those with iron-deficiency anemia, and deplete the body of vitamin A if vitamin E is taken in excessive amounts (and yet, in recommended doses, E can increase the benefits and decrease the side effects of A). When high dosages are combined with high dosages of BHA, BHT, or 2-MEA, it may shorten the life span. Beyond this, researchers are evenly divided on whether vitamin E is harmful or not. One study indicates that, in some people, doses in the 800 lU/day range may cause weakness and fatigue — symptoms which disappear a day or so after supplementation is stopped — and damage to the skeletal muscles. The findings are supported by the fact that excessive amounts of creatinine, an end product of muscle metabolism, was found in subjects' urine. Claims that it is a causative factor in phlebitis, breast tumors, and breast enlargement (in men as well as women) are unsupported by hard evidence. Vitamin E can be destroyed or rendered ineffective by birth control pills, chlorine (including chlorinated drinking water, which is common in most communities), cholestyramine, colestipol, cooking in copper pots, food processing, estrogen, freezing, heat, inorganic iron (ferrous sulfate; organic iron, such as ferrous gluconate, peptonate, citrate, or fumarate has no known adverse effect), iron supplements (in healthy individuals), mineral oil, neomycin, rancid fat and oil, Olestra, and oxygen. Individuals using mineral oil on a frequent basis may need more vitamin E, as do those eating a lot of polyunsaturated vegetable oils. If taking a multivitamin supplement with iron, make sure there is at least a six- to eight-hour span between taking the supplement and vitamin E. In 1998, the University of Arizona found that microbiologist Dr. Marguerite Kay had published erroneous research papers on aging, including one study that concluded that vitamin E had some positive effects on aging.

Dosage: Some suggest 100 to 1000 lU/day, others 800 to 1200 lU/day, with daily doses not to exceed 1600 lU/day. A dose of 400 lU/day, however, is reportedly enough to protect against heart disease (the RDA is only 30 lU/day). To increase potency, it is recommended that 25 micrograms of selenium be taken with each 200 IU of vitamin E; adequate amounts of inositol and choline should also be present in the diet. It also works synergistically with French maritime pine bark extract, another antioxidant. Those engaged in regular strenuous exercise have a greater need for this vitamin than most people. It is recommended that those who are elderly or who have digestive problems take the dry or succinate form.

AKA: Folacin, folate, vitamin Be, vitamin B-9, vitamin M, vitamin U. Folic acid is considered one of the B vitamins.

Food Sources: Almonds, apricots, avocados, beans, brewer's yeast, cantaloupe, carrots, egg yolk, flour (whole wheat and dark rye), fresh fruits, liver, milk, mushrooms, peas, peanuts, pumpkins, salmon, green leafy vegetables (such as collard greens, kale, lettuce, and spinach).

Effects: Needed for synthesis of RNA and other molecules in the brain, the manufacture of DNA coding in the cells, and helps maintain brain's protein metabolism. Preliminary studies have shown that supplementation of B-12 and folic acid may prevent or delay the onset of Alzheimer's. Combined with vitamin B-12 and methionine, it can manufacture choline in the body. According to John Mann, it may increase life span when combined with the sulfhydryl drug 4-thiazolidine carboxylic acid, and may restore hair to its original color when 5 mg of folic acid are combined with 300 mg each of pantothenic acid and PABA, along with sufficient amounts of the other B vitamins (the addition of 1500 mg of inositol, 50 to 100 mg of B-6, and sufficient amounts of protein may restore hair growth). Deficiency symptoms include bleeding gums, forgetfulness, graying hair, irritability, sore tongue and throat, occasional diarrhea and constipation, gas and abdominal discomfort, weight loss, lack of development of red blood cells, and infertility. A chronic deficiency may lead to a condition called megaloblastic folic-acid-deficiency anemia. A deficiency of both B-6 and folic acid is correlated with a high level of the amino acid homocysteine, which plays a role in heart disease.

Precautions: It should not be taken by those who are allergic to any of the B vitamins, and those with liver disease and pernicious anemia should consult a physician first. A common side effect is yellow urine; rare side effects include rash, itching, and bronchospasm. In one preliminary study dosages above 400 micrograms/day blocked the absorption of zinc in the body, though zinc levels remained within the normal range. Dosages above 1000 micrograms/day range may block the absorption of vitamin B-12, and the symptoms may include anorexia, nausea, abdominal bloating, insomnia, nightmares, malaise, irritability, impaired concentration, pernicious anemia. Permanent nerve damage may result. Supplements should not be taken by anyone with hormone-related cancer. Too high a dosage can mask symptoms of pernicious anemia. Folk acid can interact with the anti-convulsant drugs (such as sodium phenytoin) used to treat epilepsy, and may, in dosages above 1000 micrograms/day, interact with antipsychotic medication. It can also inhibit the effectiveness of sulfonamides like Gantrisin. Those with chronic liver disease may be candidates for a folic acid deficiency. Those taking methotrexate as part of a chemotherapy treatment are advised not to take folic acid supplements, as it will interfere with the effectiveness of the drug. Cases of allergies to this vitamin are extremely rare. Folic acid in the body can be destroyed or inhibited by alcohol, analgesics, antibacterial drugs, anticancer drugs (e.g., methotrexate), anticonvulsant drugs, antituberculosis drugs, aspirin, barbiturates, birth control pills, blood pressure pills such as Dyazide (triamterene and hydrochlorothiazide), chloramphenicol, coffee, cortisone, estrogen, food processing, heat, paraaminosalicylic acid (PAS), pyrimethamine, stress, sulfa drugs, sulfasalazine, sunlight, tobacco, trimethoprim, vitamin C (in dosages above 2000 mg/day), and water. It can also be destroyed by cooking, especially cooking with copper pots.

Dosage: Supplements are generally in the 100 to 800 meg/day range.

AKA: Pine bark extract, Pinus maritima, Pinus pinaster, Pycnogenol. A complex of some 40 antioxidant flavonoids and organic acids working together synergistically, it is one of the polyphenol extracts known as oligomeric proanthocyanidins (OPCs), which also include grape seed extract.

Effects: One of the most potent antioxidants available (it is 50 times more powerful than vitamin E and 20 times more powerful than vitamin C), it can extend the effectiveness of vitamin C over a longer period of time and can effectively protect against the hydroxyl free radical, which can directly damage DNA. The extract can also cross the blood/brain barrier and protect brain cells from harmful compounds in the body. It also aids the immune system, strengthens and repairs connective tissue, helps prevent heart disease, strengthens the capillaries, and has antiinflammatory properties that protect against such ailments as arthritis and allergic reactions. Studies have also shown that it can protect against stroke, stress-related ulcers, diabetic retinopathy, and some forms of cancer. It may also increase athletic performance because of its antioxidant properties, and it can relieve the symptoms of psoriasis and swelling of the lower legs. Its anticoagulant effect is five times greater than that of aspirin. Current research is attempting to determine whether it has any effect on attention deficit hyperactivity disorder (ADHD). Works synergistically with vitamin E.

Precautions: No adverse side effects have been found in doses as high as 35,000 mg/day over a six month period.

Dosage: Antioxidant expert Laster Packer, Ph.D., recommends 50-100 mg/ day.

AKA: GE-132, Germanium sesquioxide, PCAGeO, PCAGeS, vitamin O.

Food Sources: Aloe, barley, chlorella, comfrey, garlic, ginseng, onions, shiitake mushrooms, suma.

Effects: Germanium stimulates the immune system, acts as a free radical blocker, and protects against cancers, tumors, and viruses. Improves brain functioning by oxygenating the brain. It may also cure arthritis, and has been used in the treatment of AIDS, chronic fatigue syndrome, candidiasis, Parkinson's disease, cerebral sclerosis, and eye diseases. Much more research needs to be done, however. GE-132, PCAGeO, and PCAGeS are organic forms which have been shown to inhibit the growth of tumors in mice, but no studies on humans have yet been done.

Precautions: Only the organic form (sesquioxide) of germanium has the beneficial effects. Rare side effects include skin eruptions, softened stools, and kidney failure.

Dosage: It appears to have low toxicity, even in doses of 10 g/day taken for several months. Sheldon Saul Hendler, M.D., Ph.D., does not recommend supplementation until more research is done. According to James F. Balch, M.D., and Phyllis A Balch, C.N.C., a beneficial intake of 100 to 300 mg/day can be obtained through dietary means.

AKA: Activin, Resivit.

Effects: Like French maritime pine bark extract, it is one of the polyphenol extracts known as oligomeric proanthocyanidins (OPCs), and is 50 times more powerful than vitamin E and 20 times more powerful than vitamin C in its antioxidant properties.

AKA (Inositol): Myoinositol, phosphatidylinositol, phytic acid. AKA (IP6): Inositol hexaphosphate, InsP6, myoinositol hexakisphosphate, phytate, phytic acid. A sugar-like molecule that exists in large amounts in the brain, inositol is considered part of the B vitamin complex, though it is not, itself, a B vitamin. Myoinositol is the nutritionally active form, and a component of phosphatidylinositol which, in turn, is a phospholipid molecule that is a small component of cell membranes. Its plant form is known as phytic acid or IP6 (inositol plus six phosphate groups of PO4), and is one component of insoluble fiber. Food Sources (Inositol): Beans (almost all kinds), brown rice, calf's liver, cantaloupes, chick peas, most citrus fruits (lemons are one exception), lentils, nuts (almost all kinds), oatmeal, pork, veal, wheat germ, and whole-grain flour. Food Sources (IP6): In descending order: Corn, sesame, wheat beans, rice, peanuts, sunflower seeds, soybeans, barley, peas, oats.

Effects: Inositol acts as a cell membrane stabilizer. It also helps redistribute body fat, keep cholesterol low, prevent eczema, and keep hair healthy. Claims that myoinositol lowers triglycerides and cholesterol in the blood, protects against cardiovascular disease, promotes sleep, or relieves anxiety are, as yet, unproven, though these last two effects may result from its effects on phosphatidylinositol levels in brain cells. It has been shown to provide some benefit in improving sensory nerve function in those with diabetic peripheral neuropathy, though more research is needed to determine its exact role in this disease. No definite deficiency symptoms have been identified in humans. Phytic acid (IP6) is an antioxidant. It also fights cancer, protects cells (particularly blood cells) from excess iron by chelating the iron atoms. It may be a more potent cancer-fighter when taken by itself than when taken as part of a high-fiber diet, mainly because it is not bound up in protein, allowing phytase, a food enzyme, to break it down before it can be released. Evidence also indicates it may reduce lung damage from asbestos, prevent kidney stones, reduce the risk of coronary heart disease, reduce heart attacks, prevent some of the damage caused by sickle-cell anemia, and lower cholesterol. It works synergistically with green tea to reduce colon cancer.

Precautions: Frozen, canned, or salt-free foods contain less myoinositol than fresh foods. No adverse effects have been reported in those taking supplementation of myoinositol or phosphatidylinositol, though the former is the one that should be taken, as it is the nutritionally active form. Consuming large amounts of caffeine (coffee, tea, soft drinks) can deplete the amount of inositol in the body.

Dosage: Inositol has so far been found to be nontoxic in doses as high as 50 grams. Those who have taken it to relieve insomnia or anxiety have generally taken 1 to 2 g/day of myoinositol, and up to 3 g/ day have been taken for short periods of time with no apparent ill effects. The average American diet for adults provides approximately 1 g/day of myoinositol. Abul Kalam M. Shamsuddin, M.D., Ph.D., recommends 1 to 2 grams of IP6 plus inositol.

AKA: Magnesium ascorbate, magnesium gluconate, magnesium lactate, magnesium orotate, magnesium oxide.

Food Sources: Almonds, apples, apricots, avocados, bananas, blackstrap molasses, Brazil nuts, brown rice, canteloupe, corn, diary products, figs, filberts, grapefruit, lemons, nuts, peaches, seafood, seeds, soy products, sunflower seeds, green leafy vegetables, hard water, whole grains.

Effects: Magnesium provides energy; aids in the metabolism of calcium and vitamin C; enhances the immune system; plays a key role in the chemical reactions of some 325 essential enzymes; plays a role in the manufacture of DNA and RNA coding in cells; and contributes to the formation and growth of cell membranes, nerves, muscles, and the heart. It protects against anxiety, calcium buildup in neurons (a common condition found in those with Alzheimer's), depression, diabetes, fatigue, insomnia (when combined with calcium), kidney stones and gallstones, poor memory, migraines, osteoporosis, heart disease, high blood pressure, tooth decay, the toxic effects of the heart drug digitalis, and — in women — the tension of PMS and postmenopausal bone loss. Most people may not get enough, and athletes should be especially aware of their intake, as exercise depletes the body of this nutrient. In combination with vitamins C and E and choline, it may prevent some of the side effects of vitamin A and D overdoses. Magnesium orotate may help control lipofuscin deposits. Deficiency symptoms are vague and illdefined, but signs of severe deficiency include loss of coordination, loss of appetite, confusion, depression, diarrhea, headaches, high blood pressure, irritability, kidney disease, memory impairment, nausea, nervousness, vomiting, tremors, and sometimes fatal convulsions. Chronic deficiency can result in various cardiovascular problems. Even a mild deficiency can lead to abnormal heart rhythms. Because of its depletion in soil on U.S. croplands, the daily intake of the average American is about one-half to one-third of what it was nearly a century ago.

Precautions: Those with severely impaired kidney function or some types of heart rhythm abnormalities should consult a physician before taking supplements. Overdose is rare, and usually occurs in individuals with kidney failure. Magnesium salts have a laxative effect in healthy individuals in doses of 3000 to 5000 milligrams/day, and toxicity involving magnesium generally occurs in the 9000 mg range, often resulting in diarrhea. Some over-the-counter products are hidden sources of magnesium, including Bayer Plus, Bufferin, De-Gel, Epsom salts, Maalox, magnesium citrate, Mylanta, and Phillips' milk of magnesia. Magnesium can be toxic in high dosages if calcium and phosphorus intakes are also high, and it can interfere with calcium absorption if too much or too little is taken (ideally, magnesium and calcium intake should be a 1:1 to 1:2 ratio). Magnesium in foods can be depleted by poor soil conditions, milling (in grains), processing, and cooking. Magnesium absorption can be decreased by a diet high in fats and proteins, foods rich in oxalic acid (almonds, cocoa, spinach, tea), and malabsorption disorders such as Crohn's disease. The magnesium stored in the body can be depleted by the synthetic vitamin D in milk, coffee, tea, alcohol, heart medications such as digitalis and digoxin, antibiotics, anticancer drugs, anticonvulsants, diuretics, oral contraceptives, Premarin, and stress.

Dosage: A maximum intake of 500 to 750 mg/day. Magnesium ascorbate is a combination of the mineral with vitamin C, and should be in the proper proportions of one part magnesium to nine parts vitamin C.

AKA: Manganese gluconate, manganese sulfate.

Food Sources: Avocados, beans, fruits, milk, nuts, organ meats, dried peas, shellfish, green vegetables, and whole grains. Manganese is a little-understood mineral, and much more research needs to be done to determine its effects on human metabolism.

Effects: Manganese is involved in the formation of bones and the growth of connective tissue, activates some enzymes and other minerals, helps utilize vitamins Bl and E, aids in cell division and the production of DNA and RNA, and may be an antioxidant. A deficiency, which is virtually unheard of, can cause confusion, convulsions, eye and ear problems, muscle contractions, a rapid pulse, a lowering of serum cholesterol, impaired blood clotting, a reduction in the growth of hair and nails, and scaly dermatitis. Without exception, tumors are deficient in superoxide dismutase, which contains manganese.

Precautions: Overdose through diet is extremely unlikely, though miners in northern Chile exposed to manganese dust have commonly developed a disorder known as "locura manganica," or manganese madness. The first sign is a manic stage characterized by inexplicable laughter, heightened libido, impulsiveness, insomnia, delusions, and hallucinations, followed by a depressive stage of extreme drowsiness, impotence, and slowed speech. The third and final stage is distinguished by symptoms much like those of Parkinson's disease and, like Parkinson's, can be treated by levodopa. The absorption of manganese may be decreased by high dietary levels of magnesium, calcium, iron, phosphate, antacids, magnesiumcontaining laxatives, fiber (including bran), phytates in vegetables, tannins in tea, and oxalic acid in spinach.

Dosage: 15 to 25 mg/day, though some recommend 2 to 5 mg/day, not to exceed 10 mg/day. OPCs AKA: Oligomeric proanthocyanidins, PCOs, proanthocyanidins, procyanidins, procyanidolic oligomers. The OPCs are polyphenol extracts derived from plant sources, the most popular being French maritime pine bark extract (Pycnogenol), grape seed extract (Activin and Resivit), and Landes pine bark (Flavan). They have often been mistakenly referred to as bioflavonoids; they share a similar chemical structure, but OPCs are 100 percent bioavailable, nontoxic, colorless, and can bind with proteins, whereas biofiavonoids are, for the most part, not biologically active, sometimes toxic, yellow in color, and unable to bind with proteins.

Effects: The OPCs are antioxidants. They can also lower LDL cholesterol levels, reduce the risk of atherosclerosis, improve the strength and elasticity of blood vessels, maintain cardiovascular health, protect against age-related and degenerative diseases by increasing collagen's ability to repair itself, prevent edema and inflammation, relieve the symptoms of varicose veins, relieve the discomfort of PMS and menopause, reduce the probability of developing diabetic retinopathy, and maintain skin health. They are one of the keys to understanding the "French paradox," the fact that the French consume just as much dietary fat and cholesterol as Americans, yet do not suffer the same rate of cardiovascular disease, mainly due to their intake of red wine.

Dosage: Optimal dosage appears to be 100 to 200 mg/day for the average healthy individual. Grape seed extracts are superior to pine bark extracts, as the former contains 92 to 95 percent OPCs, compared to 80 to 85 percent in the latter; grape seed extracts also contain the gallic esters of OPCs, the most effective form for scavenging free radicals, while pine bark extract does not. In addition, a new process (called the phytosome process) also binds grape seed extract OPCs to lecithin, allowing them to be better absorbed by the gastrointestinal tract and more fully utilized by the body, making it preferable to the unbound form.

AKA: L-selenomethione, selenium ascorbate, selenocystine, selenomethionine, sodium selenate, sodium selenite. A trace element that, until recently, was unjustifiably considered a deadly poison. It is one of the most powerful of the antioxidant minerals.

Food Sources: Brazil nuts, broccoli, brown rice, cabbage, celery, cucumbers, dairy products, eggs, garlic, herring, organ meats (such as liver and kidneys), mushrooms, onions, poultry, radishes, sardines, shellfish, tomatoes, and tuna can have high levels. Barley, bran, whole-grain breads and cereals, brewer's yeast, and wheat germ may have high levels if grown in soil that is high in selenium, but levels can vary widely.

Effects: Selenium detoxifies heavy metals (such as arsenic, cadmium, lead, and mercury), alcohol, peroxidized fats, and some drugs; reportedly slows down some of the aging processes, and inhibits the oxidation that leads to hardening of the tissues, keeping them more elastic. One study found that 200 micrograms/ day can protect against lung, colon, and prostate cancer, but appears to have no effect on skin cancer, though it may help eradicate moles and brown spots. Other studies have correlated high levels of selenium with a low incidence of leukemia and cancers of the rectum, pancreas, breast, ovary, bladder, skin, stomach, esophagus, liver, and gastrointestinal tract. Studies have shown that, when given in doses around 220 micrograms/day, it improves moods and thinking, even in those who are not deficient, indicating most people do not get enough. Selenium has a synergistic effect when taken with vitamin E, as both are strong antioxidants. It strengthens the immune system — some say that when selenium and vitamin E are taken together, the body's antibody defenses experience a thirty-fold increase. When combined with zinc, it can improve mental performance. The only known deficiency symptom is a heart condition known as Keshan's disease.

Precautions: The FDA's recommended intake is 50 to 200 micrograms/day; an early symptom of overdose is a garlicky scent in the breath, urine, and sweat. Men, especially sexually active men, have a greater need for it than women, as this mineral is lost through semen. Selenium in its natural state is poisonous, though some say organic selenium is three times less toxic than inorganic selenium, and can cause symptoms when approximately 2400 to 3000 micrograms/day is taken over a long period of time. Some studies have found no harmful effects in people whose daily intake averages 1500 micrograms/day. Pearson and Shaw, however, claim that an inorganic form, sodium selenite, is relatively nontoxic, while selenomethionine and selenocystine — two organic forms — are potentially harmful, as the body may mistake these amino acids for sulfur-containing amino acids and make them perform functions they are incapable of carrying out. Overdose symptoms include a metallic taste in the mouth, garlic breath, skin inflammation, loss of hair, brittle or blackened nails, bad teeth, discoloration of skin, dizziness, nausea, fatigue and lethargy, gastrointestinal problems, irritability, jaundice, and progressive paralysis; acute poisoning is evidenced by fever, rapid breathing, upset stomach, inflammation of the spinal cord and bone marrow, anorexia, and death. Permanent side effects are rare, and most adverse effects disappear within a few weeks, even after several months of high dosages. The risk of toxicity is low because selenium is quickly excreted by the body; metal and refinery workers, however, maybe exposed to toxic levels, as selenium is used in the processing of some metals, though this occupational poisoning has been characterized as "mostly accidental and rare." Another risk group may be office workers who are at a copy machine all day, as these machines use selenium plates, which release this mineral into the air. There have been documented cases of cystic fibrosis patients who have become gravely ill or died after taking supplemental doses that would have been well within the safe range for the average person. Despite early reports, there appears to be no link between high selenium levels and amyotropic lateral sclerosis (ALS, otherwise known as Lou Gehrig's disease). There appear to be no contraindications with any drugs or any other vitamins, though vitamin C may decrease the absorption of inorganic selenium if taken at the same time.

Dosage: The RDA is 70 meg/day for men and 55 meg/day for women. There is no consensus on the optimal dose —some say 100 to 300 meg/day, while others claim good results with doses of up to 3000 meg/day, though these higher doses should be taken only while under the guidance of a physician. Nutritionist Nicola Reavley sets the toxic dosage at 600 to 750 meg/day; Dr. Stuart Berger sets the upper limit at 300 meg/day and Earl Mindell, R.Ph., Ph.D., at 200 meg/day, though Sheldon Saul Hendler, M.D., Ph.D., suggests 400 to 1000 meg/day is equivalent to the anticancer doses given to animals, and suggests supplementation of 50 to 200 meg/ day. Organic selenium (made from highselenium yeast) has a higher nutritional value and is more readily absorbed by the body than inorganic selenium salts (sodium selenite); most multiple vitamin supplements contain the inorganic form.

Food Sources: Dried beans and peas, lean beef, brussel sprouts, cabbage, clams, eggs, fish, garlic, onions, peanuts, wheat germ. Necessary for good complexion, healthy hair, and strong nails.

Effects: Helps provide the brain with sufficient oxygen, and also helps the blood resist bacterial infections. Sulfur works synergistically with the B vitamins to maintain basic body metabolism and strong nerves. There are no known deficiency symptoms.

Precautions: It is not known whether any overdose symptoms are associated with organic sulfur, but inorganic sulfur may pose problems.

Dosage: No RDA has been established, but since sulfur is an important component of many amino acids, those eating sufficient protein are most likely getting adequate amounts of sulfur.

AKA: Androgeron, Angiomanin, Angiomin, Cafardil, Circulan, Clofamin, Complamex, Complamin, Dacilin, Emodinamin, Jupal, Landrina, Niconicol, Sadamin, SK 331 A, Vasoprin, Vedrin, Xanidil, and Xavin. A form of niacin that passes through cell membranes more readily than niacin.

Effects: Xanthinol nicotinate increases ATP production, dilates blood vessels, and improves shortterm memory.

Precautions: People with ulcers, cardiovascular problems, or liver problems (xanthinol nicotinate can cause liver dysfunction) should avoid taking it. There may be minor reactions such as blurred vision, diarrhea, headaches, heartburn, heart palpitations, itchy skin, muscle cramps, nausea, skin flushing or a sense of warmth, skin rash, skin-color changes, or vomiting; these generally disappear with continued use or when use is discontinued. It may cause postural hypotension, or a sudden drop in blood pressure when going from a sitting to a standing position.

Dosage: 300 to 600 mg/day in three divided doses with meals.

AKA: Chelated zinc, Egozinc, Orazinc, PMS Egozinc, Verazinc, zinc chloride, zinc acetate, zinc ascorbate, Zincate, zinc gluconate, Zinkaps-220, zinc pyrithione, zinc sulfate, Zinc 220. A mineral important to many of the brain's enzyme systems, it is a component of 90 essential enzymes, including superoxide dismutase. Most of the medical research has been done with zinc sulfate, which is 22 percent zinc by weight; however, most of the supplements sold to the public are zinc gluconate, which is 14 percent zinc by weight and is not widely researched. There are no studies comparing the two. Likewise, almost nothing is known about chelated zinc. Zinc acetate causes fewer gastrointestinal problems than the other forms, yet is not widely available. Zinc pyrithione is used for shampoos and hair conditioners and is not intended for oral use.

Food Sources: Beef, blackstrap molasses, bran (wheat and rice), egg yolk, fish (particularly herring), lamb, legumes, liver, nonfat dry milk, ground mustard, nuts, organ meats, oysters, pork, poultry, pumpkin seeds, seafood and shellfish, soybeans, sunflower seeds, turkey, wheat germ, whole-grain flour. The zinc content of vegetables is dependent on the soil in which they are grown. More readily available zinc is found in meats than from other sources.

Effects: Zinc is important in protecting cell membranes against free radical damage, essential for the growth and development of the reproductive organs, helps the body get rid of carbon dioxide, helps in the manufacture of DNA and RNA, aids in the smooth contraction of muscles, and boosts the immune system. It also helps the body absorb vitamins (especially the B vitamins), synthesize proteins, metabolize carbohydrates, and form insulin. There are significant amounts of zinc in the brain, which may help protect against lead poisoning from the environment. Additional reported benefits include faster healing of wounds, a restoration of loss of taste, protection against prostate problems, and lower cholesterol deposits. It has been used to treat psoriasis (when used in combination with sulfur), acne (when used in combination with vitamin A), rheumatoid arthritis, impotence, and irregular menses. Zinc gluconate is said to help speed recovery from the common cold. When combined with selenium, it may improve mental performance. Some say that a combination of zinc and manganese supplements help guard against senility.

Precautions: It should not be taken by anyone with an upper respiratory infection. Rare side effects, which occur with an overdose, consist of chest pain, chills, dizziness, drowsiness, fever, heartburn, indigestion, nausea, shortness of breath, sore throat, extreme fatigue or weakness, ulcers in the throat or mouth, vomiting, and yellow eyes and skin. Any stomach discomfort can usually be avoided by taking zinc after meals or with milk. Some have reported mouth irritation and taste distortions when dissolving lozenges (those made for swallowing) in the mouth for 10 to 20 minutes. Too much zinc, which can even occur from eating too much high-zinc foods or from foods which have been stored in galvanized containers, can interfere with the body's absorption of copper. Dosages above 80 mg/day can cause levels of high-density lipoprotein-cholesterol (the "good" cholesterol) in the blood to fall, possibly leading to heart disease. The dosage normally used for treating acne, 135 mg/day, is very near the toxic level for some individuals, and some may experience the overdose symptoms mentioned above. Dosages above the 50 to 150 mg/day range can cause severe anemia due to iron and copper deficiency (Conversely, a high level of copper can collect in the blood and sap the brain's supply of zinc). Zinc supplements can also irritate the stomach lining and perforate ulcers. Those involved in smelting operations can suffer from zinc poisoning by inhaling the fumes. On the other hand, some feel that zinc deficiency is very common in the U.S., and is often characterized by hypogeusia (a loss of taste and smell), scaly skin, slow healing of wounds, depression, fatigue, mental dullness, difficulty in concentration, hair loss, decline in the number of red and white blood cells, diarrhea, lowered resistance to infections, low sperm count and, in severe cases, atrophy of the sex glands. Alcoholics, diabetics, strict vegetarians, and heavy exercisers need higher than normal levels of zinc, as do persons eating high-fiber diets, living in hot climates (heavy sweating depletes the body's supply to a significant extent), or taking vitamin B-6 supplements. Medical conditions associated with insufficient zinc in the body include chronic infections or inflammatory diseases, kidney disease, pancreatic disease, psoriasis, sicklecell anemia, and thalassemia. Whole grains and breads that have been prepared without yeast have a high level of phytic acid, a phosphorus compound that prevents the body from absorbing the zinc in the food; this is especially true if extra bran has been added (though phytic acid is now believed to prevent colon cancer). Also, cadmium, a toxic mineral which can be found in food as a result of pollution, can take the place of zinc where both are present. This is a problem with white bread, in particular, because zinc is concentrated in the bran (largely absent from white bread), whereas cadmium is concentrated in the white part of the grain. A zinc deficiency can make a vitamin A deficiency worse (conversely, zinc supplements may increase the need for vitamin A). Zinc can be destroyed or inhibited by alcohol, bran, cadmium, EDTA (a food additive found in beer, canned foods, soft drinks, and foods high in vegetable oils), fiber, phosphorus-containing additives used in foods, phytic acid (phytates), stress, folic acid supplements, iron supplements, and tobacco. Decreased absorption of zinc can be caused by tetracycline (Achromycin V, Mysteclin F, Sumycin). Other drugs that inhibit or deplete zinc include penicillamine and the antibiotics chlortetracycline (Aureomycin) and oxytetracycline (Terramycin). There is one case where the anticancer drugs mercaptopurine (Purinethol) and methotrexate caused a deficiency. Corticosteroids, or cortisone medications, may cause an excessive amount of zinc to be excreted and may retard wound healing. These medications include dexamethasone (Decadron), prednisone, prednisolone (Deltasone), betamethasone (Celestone), desoxycortisone (Percoten), and methyprednisolone (Depo-Medrol, Depo-Predate). Diuretics like chlorthalidone (Combipres, Hygroton, Regreton) and thiazide diuretics may also increase the excretion of zinc. Metal-binding drugs such as penicillamine (Cuprimine) can cause zinc to bind with copper, which can lead to a deficiency in the long run. Birth control pills increase the amount of zinc in the red blood cells but, as yet, the consequences of this have not yet been determined.

Dosage: Doses higher than 15 to 30 mg/day are not recommended, as long-term effects are not known. Zinc sulfate and zinc gluconate are both well tolerated by the body, but the latter is less susceptible to side effects; in both, side effects occur in many individuals in the 100 to 200 mg/day range, but taking frequent small doses throughout the day with meals may prevent some of these. If high doses of vitamin B-6 are taken, there is a greater need for zinc, especially for alcoholics or diabetics. The best supplements to take are those composed of chelated zinc. Individuals taking zinc should take adequate amounts of vitamin A, calcium, and phosphorus for zinc to work with maximum efficiency.

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