December 9, 2011

The Risks of Excess Vitamins and Other Nutrients

This is an excellent topic to fit with the last two on supplements and multivitamins. I do not think about it generally because I am aware of the difference between fat and water-soluble nutrients. I do not consciously think about this because of the few supplements I do take, but I do tend to be more careful with fat-soluble because the body does not automatically flush excess out of the body.

The body sometimes does not automatically flush excess water soluble, but in general, it does. Water-soluble excess is generally flushed and not stored by the body. There are exceptions that you need to be aware. Too much vitamin B6 can cause nerve damage. Excess niacin can cause flushing and excess vitamin C may cause kidney stones. A serious problem may be caused by excess folic acid, which may mask vitamin B12 deficiency and is most common in people over the age of 50.

Fat-soluble is dissolved in fat and stored by body tissues for use later. However, fat-soluble is not equal as Vitamin D is a hormone and apparently allows higher tolerances than other fat-soluble vitamins. Vitamin D is one of the more controversial vitamins as many think the Institute of Medicine (IOM) has set the limit too low for the needs of the body. Many are claiming vitamin D has more health benefits than it may have.

Vitamins A, E, and K are also fat-soluble. Because they are stored, over time they can rise to dangerous levels and lead to a condition called hypervitaminosis. This means excess amounts of a vitamin in the body that are unhealthy and can cause health consequences. Excess vitamin A in women can cause birth defects and too much vitamin E may increase the risk of hemorrhaging. Excess vitamin K can reduce the effect of blood thinner medications and prevent normal blood clotting.

Exceeding the recommended daily allowance (RDA) of many nutrients can cause the vitamins to act like drugs and may lead to health problems. Research has shown at what levels nutrients can cause potential problems and these levels do take into account all sources of vitamins and minerals from food, fortified food and supplements.

Fortified foods is a way for people to help fill the nutrient gaps and has resulted in production practices of adding iodine to salt, enriching grains with vitamins B and iron, and milk fortified with vitamins A and D. In combination with whole foods, supplements, and fortified foods is raising concerns from the experts. These concerns are that the supplements may cause the diets of people to exceed the safe upper limits and potentially lead to a toxic buildup of certain nutrients.

Even though the article advises consulting a doctor, I am leery of this because many doctors will advise against supplements without doing any testing to determine if there are deficiencies to be concerned about. Consulting a dietitian is good advice. Even with this, it is still wise to know the upper limit for vitamins and minerals that you are taking, check all labels of your food choices to know which food are enriched with the same nutrients.

Carefully read the article by WebMD and read the previous two blogs on supplements and multivitamins. Here's to your good health!

December 8, 2011

How to Choose a Multivitamin

Again, WebMd has an article when needed. The last blog about supplements was inline with this. We do need to be aware of supplements and which ones are age appropriate. It appears that the food industry goes out of their way to prevent balanced nutrition with the highly processed foods we are exposed to in the stores. It should not be that difficult to eliminate the highly processed foods, but occasionally they can be substituted with little nutritional damage, but only occasionally.

If you are using supplements to fill in the nutritional gaps, you may want to consider a multivitamin. We do not always use the best eating plans or have a dietitian or nutritionist available to consult on a regular basis, so depending on the test results from your doctor, you may need a multivitamin to fill in the gaps. If so, which one do you chose when you are looking at the large variety on the shelf? I would encourage you to read the WebMd article as it covers many points.

First, make sure that your daily food intake includes a variety to be complete in nutrients as possible. This may eliminate the need for a multivitamin, but depending on the tests done by your physician, do consider supplements or a once daily multivitamin if necessary. “The 2010 Dietary Guidelines for Americans identified calcium, vitamin D, dietary fiber, and potassium as nutrients of concern for inadequate intake in adults and children. All of these nutrients, except fiber, come packaged in a multivitamin. Fiber can be obtained as a separate supplement, but it's still best to try to get all your fiber from the foods you eat.” 

Some pointers to consider while looking over the variety of multivitamins include: reading the label carefully, getting the basic vitamins and minerals, check the percentages of what the multivitamin has listed, look for extras that you may not need or do need, check the formulas for men, women, and age, and do not overdo the multivitamin routine.

Look for the multivitamin that fits your sex, stage in life, and your health conditions. This more than a salesperson's promotion should determine what is appropriate for you. Most multivitamins are sold in capsule form, but they are also available as tablets, powders, chewables, and gummies. Liquids and injectable formulations can be found that can be administered by healthcare providers.

Supplements and multivitamins can lose their potency over time and especially when improperly stored. Also, check expiration dates, store in a cool dry place and avoid hot, humid places like the bathroom. Make sure that the location is secure and out of the reach of children.

It really does not seem to matter when you take the multivitamin, but taking it with food can be an advantage in lessening stomach discomfort. “A measure of safety is to look for the designation "USP" on the label. A multivitamin that meets the requirements of the U.S. Pharmacopoeia (USP) meets the standards and ensures the product is pure and actually contains the listed ingredients.” Always consult your health care provider when taking any supplement or multivitamin to be sure that they will not have conflicts with prescription medications.

December 7, 2011

Are You Using Supplements for the Right Reasons?

Are you using supplements for the right reason? Many do not and take a cocktail of supplements based on what the salesperson says. This can lead to over taking many of the supplements and creating a toxic effect when the supplements are not needed. Think about it for a while and decide if you are on this path.

The promises of the salesperson and claims on the packages are not the reason to be taking them. We all know that there may be a temporary energy boost, but this will not last long. The supplements will not help with weight loss, reduce stress, or reduce wrinkles. Yet many people take supplements for these reasons and spend money for pie-in-the-sky reasons.

Experts agree that there is a proper place for vitamin and mineral supplements to fill gaps in our nutrition. They should not be used to take the place of real food because they will not replace other important nutrients we obtain from eating healthy meals. Yet it is common knowledge that may people do this and can create other shortages in their diet that real food can meet the needs for and fulfill.

This blogger has the right attitude about supplements and rightly believes in obtaining supplements in their natural state from food. Supplements cannot replace every nutrient and benefits of whole foods. Supplements are meant to do just that, supplement gaps occurring in your diet. It is best to obtain your nutrients from food first and fill the gaps with supplements. A pill does not contain the phytochemicals and fiber necessary that eating whole foods can supply.

Learn that your doctor does many tests to see which essential nutrients you are not getting in the foods you eat. By obtaining copies of your lab tests and tracking them, you will soon learn which supplements to add to your intake and avoid those that have little to no benefit. We all need to keep the levels of calcium, potassium, magnesium, vitamin D and Vitamin B12 at proper levels and your doctor can help determine these with the proper tests. You may need to have a long conference with your doctor as many do not see the value in any supplements and will tell you not to take them. This is where research on the internet may become necessary for some of them.

Beyond filling in gaps, other studies have demonstrated that supplemental vitamins and minerals can be advantageous. However, the exact benefits are still unclear as researchers continue to unravel the potential health benefits of vitamins and supplements.”

If your doctor agrees that you need supplements, remember to take them. They can do nothing if left in the bottle. Set up a daily routine for taking them and follow it. Remember too if what the salesperson or the packaging advertising says is something that is too good to be true, it probably is. You should avoid those making unrealistic claims. Expect only what it would do for you if you were eating sufficient quantities in your food, not what people want you to believe to make a sale.

Take time to read the WebMD article carefully as it has some pointers not included above.

December 6, 2011

Why Do You Let Teaching Moments Pass?

I could list many people that write about this, but I am interested in why they let teaching moments for diabetes get away from them. This raises many questions and provides very few answers.

Is it the setting, the time, or the place that stops them? Are they people that want to keep their diabetes a secret to be kept in a closet? Are they too embarrassed to speak up? Or, is this an invisible disease that keeps people tongue-tied?

When compared to breast cancer, awareness on a national level is more recognizable and better advertised. People have ribbon stickers on their cars, have larger, more publicized events and in general have come out of the closet in their battle against breast cancer.

What is it going to take to get the diabetes community to come out of the closet? The International Diabetes Federation (IDF) is trying to lead the way in a color and a symbol. But the American Diabetes Association (ADA) is determined not to become part of this effort. They want their own color and their own symbol and seem to downplay the efforts of the IDF.

However, let the IDF have some success and the ADA will find a way to either hog the credit or say they had a large part in it. Sometimes they have a legitimate claim to a little of the credit, but they seem to want to have it all. Not a very professional or humanitarian thing to be doing is the way I view this.

The ADA does little to promote coming out of the closet and using education to promote the prevention of diabetes or giving the support to adult patients with diabetes. The ADA does not promote discussing diabetes to help people understand this chronic disease to the general public. They do not promote many activities for the cure of diabetes. The ADA is basically an association of and for doctors and this they do poorly. Why else would there be so many doctors that will not aggressively work to diagnose diabetes and try to stem the rising epidemic of obesity.

The only claim that the ADA can make is their enforcement of laws on the books protecting children and their rights in the public school system. They do also use the Americans with Disabilities Act laws to protect the rights of people with diabetes. This is their only claim to fame. While medical professionals look to the ADA for guidance in the field of diabetes, the ADA is very much behind the times in its pronouncements and guidance about the types of diabetes and effective ways to treat diabetes. Often this is five to ten years after the medical professionals have made the decision on their own.

There is research available and verifiable, but the ADA keeps looking for more on which to base a directive or issue guidance. This in turn leaves the patient with little to rely on in discussions and trying to make sound decisions for their own health.

Therefore I lay the fault of why patients avoid educating others about diabetes on the steps of the ADA and the medical profession. They wish to be the ones controlling the patients and having patients totally rely on them. The ADA feels that patients are incapable of learning about this chronic disease called diabetes. Before you think I am totally against the ADA (which I am), they are responsible for American Diabetes Month, but do little to promote education within this month.

Now that the American Association of Clinical Endocrinologists (AACE) has a web site of approved and vetted diabetes sites (this is still in the formative stage and more sites need to be added), will the ADA follow and claim credit. I can see the press release about how they have had all the information available on their site. Yes, it may be there, but finding it and having access to it are two different things, both equally difficult and often costly, as they will not offer much freely, but for a fee. The AACE did think to include the ADA on their list of approved and vetted sites.

December 5, 2011

Another First in Patient Care

Apparently, with changes in the health care system and the likely decrease in Medicare funding projected for the next year, changes are happening especially in medical offices that now have electronic record systems in place and operating. On Tuesday, I was in the lab for tests and on the wall was a sign asking patients to notify lab personnel of any lab work done in the last 30 days in the hospital and hospital clinics.

I did this and the person headed for the computer and pulled up the lab results and said that makes only the A1c test left. Therefore, that was the only test that needed to be performed before seeing the endocrinologists. Before, this would not have stopped duplicate tests. Times are changing.

A1c was the same as my last visit. This was better than I had expected considering the surgery and my blood glucose results since then. Maybe my extra care in the two preceding months helped. I would like to think so and hopefully it would have been under 6.0 if not for the surgery.

I did comment on this to the endocrinologist and she stated this was a new policy and that yes they were doing this to avoid duplication of tests performed within the last 30 days. I asked how they liked the computer system. It is saving money and making communications between doctors, labs, clinics, and the hospital much easier. They are still keeping the manual records and updating them as fast as possible into the computer.

I am sure what they are all waiting for is the Medicare payments to come faster and the savings to be distributed. I cannot say I blame them with the proposed cuts that may take place unless our Congress gets their act together. Does not seem likely considering the status of affairs. Yet, the Department of Transportation keeps awarding millions almost weekly for this project and that project.