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Q: Do I really need to take vitamin and mineral supplements?

A: The supplement industry has boomed over the last few years. It is said that, because our diets now consist of more processed foods we are not getting the necessary vitamins and minerals. This might be true to some extent, but not exclusively so.

Let us look at some arguments for supplements. Some people are medically diagnosed as deficient in certain vitamins and minerals; for example, people who are anaemic have an iron deficiency; hence, they need iron supplementation.

There are, however, different kinds of anaemia that need different therapies. An individual cannot just make a decision to go to the pharmacy to buy an iron pill. How does one know how much iron he should get, what form the iron should be in, and what the route of administration should be? The answer is: A patient cannot determine this. So it is necessary for the patient to visit a doctor. The doctor will do tests and recommend the best line of treatment based on what is going on for that individual patient. So supplements are necessary when there is a diagnosed deficiency of a vitamin or mineral.

On the other hand, it can be argued that taking supplements is not absolutely necessary. Quite honestly, deficiencies in most vitamins and minerals are rare because we get these essential elements from such varied food sources. In addition, the food processing industry enriches a lot of foods with vitamins and minerals; for example, salt is commonly enriched with iodine. In the western world, where everything is salted, we certainly are not deficient in iodine.

Breads are typically enriched with B vitamins. Wheat naturally contains B vitamins but in the processing of the grain to produce flour, the wheat is stripped of its natural vitamins; hence, bread manufacturers add back B vitamins to the bread to enrich the product. Iron and folic acid are also commonly added to breads.

Dairy products, margarine, vegetable oils, and breakfast cereals are normally enriched with vitamin D. Vitamin D helps in the absorption of calcium from dairy products; hence, it makes sense to add it to milk and breakfast cereals, which will be eaten with milk.

Our final example is of fruit or fruit-flavoured juices, which are enriched with vitamin C. Calcium is also commonly added to fruit juices.

With all this fortified and enriched food, are we overdoing it if we take supplements? The US Food and Drug Administration has outlined daily recommended values for vitamins and minerals. If we drink two glasses of orange juice plus take a vitamin C tablet, plus eat some fruit like orange or pineapple, we will most certainly exceed the daily recommended intake of vitamin C and this can cause adverse effects. Too much vitamin C can actually cause diarrhoea, kidney stones, or gout. In a similar manner, too much vitamin B2 can turn the urine into a bright yellow colour; too much vitamin B3 and B5 can cause nausea, heartburn, and diarrhoea; too much calcium can cause constipation and kidney stones; too much magnesium can cause a heart attack; too much vitamin A during pregnancy can cause birth defects; and too much zinc causes gastrointestinal upset.

So, with the food industry adding vitamins and minerals to almost all processed foods, is it still necessary to take vitamin and mineral supplements? This question requires discussion with your doctor or pharmacist as each patient’s therapy has to be individualised.

In conclusion, there is a place for vitamins and minerals, particularly in deficiency diseases. However, the food we eat, whether fresh or processed, provides us with all these nutrients as well. If we are not eating well, we can definitely pursue supplementation, but supplements should not seek to replace food as they cannot provide carbohydrates, proteins, and fats in the proportions needed by the body. Hence, supplements have to be regulated by your doctor or pharmacist.

Novia Jerry Stewart, MSc, RPh, is a pharmacist who specialises in ophthalmic care. She may be contacted at novia_jerry@yahoo.com.