"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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This page has been printed from the www.stewartnutrition.co.uk web site.


Guide to Nutritional Supplements

Nutritional supplements are used by over 40% of UK adults and the industry is worth over £200 million per year.  The majority of supplements are in fact taken by those with the best diets and many are taken without professional advice.  According to the National Diet and Nutrition Surveys the current pattern of use is for many nutrients only associated with a reduction of approximately 1% in the percentage of the population whose intake is poor, below the Lower Reference Nutrient Intake, for that nutrient.

Where possible, nutritional deficiencies should be resolved by dietary means but this is not always achievable and those with a severe deficiency or an established illness may require a more rapid resolution than can be obtained by diet alone.  Judicious use of supplements will be beneficial to many with or at risk of deficiency and the following guide is intended to help those whose problems cannot be resolved by diet alone.
Those who choose to take supplements should still make every effort to eat a healthy and appropriate diet.

Reference to nutritional supplements is purely generic and there is no direct link from this website to that of a supplement manufacturer or retailer.  The reader is also advised, before purchasing or taking a supplement to check that they do not have a major contraindication to taking nutritional supplements or a minor contraindication.  Those who are under the care of their GP or specialist should also seek appropriate advice.  Furthermore it may be unwise to take supplements for a Persistent period of time without seeking advice from your doctor or a dietician or qualified nutritionist.

Readers should be informed that the author is in receipt of a small royalty from the sale of one particular nutritional supplement but no mention of that supplement nor its manufacturer is made on this web site.


Guide to Common Nutritional Supplements
Type of Supplement Typical Composition Main Uses Comments and Warnings
General A to Z multivitamin/mineral RDA amounts of most vitamins, trace elements and some calcium General use by adults age 18 to 49 years Use with Cod Liver Oil may provide too much vitamin A
50 + A to Z multivitamin/mineral As above but with higher amounts of vitamin D and trace elements General use by adults aged > 50 yrs Use with Cod Liver Oil may provide too much vitamin A
Simple multivitamins with iron RDA amounts of vitamins and iron Menstruating women especially those with heavy periods Use with Cod Liver Oil may provide too much vitamin A
Pre-pregnancy or pregnancy multivitamins RDA levels of vitamins, iron and zinc + folic acid 400ug Those who are trying to become or are pregnant Must contain 400ug of folic acid in order to prevent birth defects
Vitamin A Content should not exceed 800 ug/daily dose Those with or at risk of deficiency, which is rare Persistent use may increase the risks of cancer and osteoporosis
Beta-carotene 7-15 mg Those with or at risk of  vitamin A deficiency Smokers and those exposed to asbestos may develop more lung cancer
Low dose vitamin B complex 1-5 mg of most B vitamins Those at risk of mild deficiency May not contain folic acid and other B vitamins
High strength vitamin B complex 10-100 mg of most B vitamins Those with severe deficiency especially heavy alcohol consumers May discolour urine yellow due to the riboflavin – vitamin B2
Folic acid 400 ug Those who are trying to become or are pregnant A pregnancy multi supplement maybe more appropriate for those with a poor diet
Vitamin B12 1-10 ug Those with or at risk of dietary deficiency e.g. vegans No contraindications
Niacin 50-500 mg Those with elevated blood cholesterol level Flushing and itching occurs frequently
Pyridoxine
(Vitamin B6)
10-100 mg Women with premenstrual syndrome Doses >200mg/day can cause peripheral neuropathy
Biotin 200-1000 ug Those with or at risk of deficiency No contraindications
Vitamin C 100-1000 mg Those with or at risk of deficiency: smokers, elderly and a poor diet Deficiency is corrected within a few weeks
Vitamin D 10 ug Those with or at risk of deficiency Calcium supplement are also often needed if intake is inadequate
Vitamin E 200-600 IU To lower the risk of vascular disease Benefits are unclear
Vitamin K Rarely available alone Used now as apart of multi preparations and to treat osteoporosis Inappropriate for those on warfarin medication
Calcium and
Vitamin D
500 mg + 5 ug For the prevention and treatment of osteoporosis and for those with an inadequate diet or increased need Often used in the elderly, others with an increased risk of osteoporosis or an inadequate diet especially if pregnant or breast-feeding
Calcium 200-600 mg For those with an inadequate diet or increased need Vitamin D or multi- vitamin supplement may also be needed
Calcium and magnesium 300 mg  + 150 mg For those with an inadequate diet or increased need Only use if both minerals are required.  Excess may cause diarrhoea
Magnesium 75-150 mg Those with or at risk of deficiency or if constipation or premenstrual syndrome Excess Magnesium may cause diarrhoea
Iron low dose 5-15 mg Those with or at risk of mild  deficiency Better absorbed if taken with fruit  / juice
Iron high dose 30-65 mg Those with anaemia or proven iron deficiency e.g. from very heavy periods or bleeding Better absorbed if taken with fruit  / juice. Excess may cause diarrhoea and black stools
Zinc 5-30 mg Those with deficiency e.g. elderly, weight loss and malabsorption May rarely cause abdominal pain. Persistent use should be supervised.
Chromium 100-200 ug Those with deficiency e.g. elderly and poor diet Seems very safe
Selenium 100-200 ug Those with or at risk of deficiency Persistent use might increase the risk of diabetes
Selenium and Vitamins A, C and E 100-200 ug + variable To help immune function and inflammatory conditions Persistent use might increase the risks of diabetes and cancer
Copper 1-2 mg Rarely required except by those with deficiency Do not use for Persistent periods
Evening Primrose Oil 500-1000 mg To help eczema, other skin problems and premenstrual breast tenderness No contraindications
Borage Oil 500-1000 mg To help eczema, other skin problems and premenstrual breast tenderness No contraindications
Cod Liver Oil capsules Vitamins A + D + EPA/DHA To help arthritis, other inflammatory conditions, heart disease and prevent deficiency Those who also use multivitamins may receive too much vitamin A
Cod Liver Oil Liquid Vitamins A + D + EPA/DHA To help arthritis, other inflammatory conditions, vascular disease and prevent deficiency Those who also use multivitamins may receive too much vitamin A
Fish Oil EPA/DHA To help arthritis, other inflammatory conditions and vascular disease Very high intakes might increase the risks of bleeding and possibly skin itching


Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
47 Priory Street, Lewes, East Sussex. BN7 1HJ
Tel 01273 487003 Fax: 01273 487576