ADRs of irrational use of nutritional supplements

[Guest guest]

Hello Dr Anupama and Netrumians,

A good nutrition plays an important role in disease prevention. But controversy continues to swirl around the use of supplements as treatments for many existing medical conditions. Many people mistakenly think vitamins and other nutritional supplements are safe because they are "natural". That may have been true once, when nutrients were consumed only in their natural form -- in food.

Here I am giving adverse drug reactions of the most commonly prescribed vitamins such as à

Vitamin A

Contraindications

Women should not take vitamin A supplements during pregnancy. Dosages greater than 10,000 IU during pregnancy (specifically during the first 7 weeks after conception) have probably been the cause of 1 in 57 cases of birth defects in the United States. Women who may become pregnant should keep doses of vitamin A below 5,000 IU daily.

Possible Adverse Effects

Vitamin A toxicity is by far the most widely reported problem arising from supplement overdoses. Even so, only 200 cases (unrelated to pregnancy) are thought to occur worldwide each year. How much vitamin A causes problems? The answer varies with the individual. Doses of 25,000-50,000 IU daily for several months can be toxic for people with liver problems, drugs, for heavy drinkers.

Vitamin B6 (pyridoxine)

Contraindications

Diabetics should use B6 only under the supervision of a skilled practitioner, since it may affect blood sugar levels. Vitamin B6 may affect the actions of anticonvulsant medications, so epileptics should take it only under skilled supervision.

Possible Adverse Effects

This is a controversial issue, but some people who take high doses of vitamin B6 over a long period of time may experience symptoms such as tingling, numbness, or weakness in the extremities due to nerve damage. But studies indicate that doses smaller than 500 mg per day appear to be safe.

Vitamin C

Contraindications

Diabetics should take vitamin C supplements only under supervision, since it may affect blood sugar levels. People with genetic iron disorders should consult their physicians before using vitamin C supplements, since it increases the rate of iron absorbtion.

Possible Adverse Effects

Vitamin C is generally regarded as one of the safest vitamins. Too much vitamin C can cause diarrhea.

Based on early studies, there has been some concern that taking vitamin C might increase the risk of developing kidney stones. But more recent research have found no corroborating evidence of any link between vitamin C and kidney stones. Some researchers believe that abruptly ending high-dose vitamin C supplementation can cause "rebound scurvy" the vitamin C deficiency disease. exact cause is not known, but it is probably wise to reduce high doses gradually.

Folic Acid

Contraindications

Folic acid supplements may reduce the effectiveness of methotrexate , colchicine, trimethoprim , pyrimethamine , and phenytoin .If you're taking any of those drugs, consult your physician about using folic acid. High doses of folic acid may increase seizure activity in epileptics. Folic acid can mask symptoms of vitamin B12 deficiency (pernicious anemia).

Possible Adverse Effects

People at risk for pernicious anemia should use folic acid supplements only under medical supervision. Risk factors include a family history of the condition, as well as some autoimmune endocrine diseases such as type 1 diabetes, hypoparathyroidism, 's disease, hypopituitarism, testicular dysfunction, Graves disease, chronic thyroiditis, myasthenia gravis, secondary amenorrhea, vitiligo, and candidiasis.

Niacin

Contraindications

Diabetics should use niacin only under supervision, since it may affect blood sugar levels. Niacin should be avoided by people with liver disease, gout and peptic ulcers. Niacin may affect anticonvulsant medications taken by epileptics and should be used only under medical supervison.

Zinc

Contraindications

People with high cholesterol should use zinc only under supervision, since high doses of zinc may elevate cholesterol levels in some cases.

Possible Adverse Effects

High doses of zinc (100-300 mg daily) can impair immune system function. Taking too much zinc can also lead to severe copper deficiency.

Fiber

Contraindications

Fiber supplements in pill form should not be taken by people with esophageal disorders, since they may expand and cause an obstruction.

Possible Adverse Effects

Increasing dietary fiber may cause gas and abdominal discomfort until the body adjusts. Fiber supplements may also interfere with the absorption of drugs, so it's best to separate the two by a couple of hours.

Regards,

Dr Deepali

GMC,Nagpur

[Guest guest]

Thanks Anupama for remembering the issue. Our article about that is

appearing in the forthcoming issue of " Indian Journal of Medical

Ethics " and can also be viewed on web.

Vijay

>

> Dear all,

> As we head to the mid of the discussion, would you like to quote

instances where there were disasters due to overuse of vitamins,

minerals etc?

>

> One is well known(Dr Vijay had mentioned that)-In Nagpur and

Assam many children got ill after taking multiple doses of Vit A.

>

> Try quoting many more.

> Anupama.

>

>

> ---------------------------------

> Unlimited freedom, unlimited storage. Get it now

>

[Guest guest]

Dear Dr Vijay, Congrats for getting this issue published. Atleast then our DRAs and Health department will wake up -its high time they realize their duties! Congrats once again Anupama. Vijay <drvijaythawani@...> wrote: Thanks Anupama for remembering the issue. Our article about that is appearing in the forthcoming issue of "Indian Journal of Medical Ethics" and can also be viewed on web.Vijay>> Dear all,> As we head to the mid of the discussion, would you like to quote instances where there were disasters due to overuse of vitamins, minerals etc?> > One is well known(Dr Vijay had mentioned that)-In Nagpur and Assam many children got ill after taking multiple doses of Vit A.> > Try quoting many more.> Anupama.> > > ---------------------------------> Unlimited freedom, unlimited storage. Get it now>

Get the freedom to save as many mails as you wish. Click here to know how.

[Guest guest]

Hi ,

Thanks. Keep blessing.

Vijay

> >

> > Dear all,

> > As we head to the mid of the discussion, would you like to quote

> instances where there were disasters due to overuse of vitamins,

> minerals etc?

> >

> > One is well known(Dr Vijay had mentioned that)-In Nagpur and

> Assam many children got ill after taking multiple doses of Vit A.

> >

> > Try quoting many more.

> > Anupama.

> >

> >

> > ---------------------------------

> > Unlimited freedom, unlimited storage. Get it now

> >

>

>

>

>

>

>

> ---------------------------------

> Get the freedom to save as many mails as you wish. Click here to

know how.

>