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Spokane, Washington  Est. May 19, 1883
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House Call: Vitamins, supplements may not be necessary

By Dr. Bob Riggs For The Spokesman-Review

If you eat a wide variety of fruits and vegetables as well as mostly plant-based protein sources, chances are that you don’t need vitamin supplementation. I would recommend to anyone who has doubts about their diet to keep a food diary for a week and then have a discussion with your health care provider to see where and if any improvements need to be made. Your body absorbs vitamins and minerals from the food you eat far more efficiently and effectively that it does from supplements, so making changes to you diet is the most effective way to avoid any vitamin or mineral deficiencies.

However, there are instances where a vitamin supplement is likely to be in order along with a healthy diet. For instance, I always recommend a prenatal supplement that contains folic acid to women who are pregnant or trying to get pregnant. Folic acid is essential to healthy fetal development and lowers the risk of the baby developing neurological problems such a spina bifida. Up in the far north, people are at risk for vitamin D deficiency due to low sun exposure. Most organizations recommend vitamin D intake of between 600 IU and 1,000 IU daily depending on age; higher doses may be necessary for people that are vitamin D deficient.

Some medications, such as certain acid-lowering medications for eliminating chronic heartburn and gastrointestinal reflux disease (GERD), can be associated with vitamin or mineral deficiencies even with a healthy and varied diet. There are medical conditions that can cause vitamin deficiencies too. For example, people who have had weight loss surgery do not absorb some vitamins and minerals as well as others and likely need some supplements. They should consult with a nutritionist. Sometimes the deficiency can be reversed by changing medications or treating the condition and sometimes a supplement may be required.

Always talk to your health care provider to see if vitamin supplementation is right for you. Self-diagnosis may just cover up an underlying issue and it is better to treat that first and see if the deficiency goes away or improves before turning to supplements.

If you do need supplements, be vigilant about what you buy. The FDA does not regulate or inspect them and this includes vitamins and minerals. Even a vitamin or mineral supplement that is labeled natural may have toxins or contaminating organisms in it because the term has no strict definition and appropriate ways to use or not use it have not been outlined. This means literally anything that is a supplement can have the word natural on the label no matter how it is made or what it is made of.

To make sure your vitamin or mineral supplement is free of toxins and contaminants, look for labels that indicate it has been tested and certified by an independent lab such as US Pharmacopeia, Consumer Lab, or NSF International.

It’s also important to make sure your health care provider knows all of the medications you are currently taking before you start a supplement. There are instances where a vitamin or mineral may interfere with the absorption of your medication. This could result in you not getting the amount of medication you need to treat your medical condition. Sometimes these kinds of interactions can be avoided by taking the medication and the supplement at different times of day. Always be sure to find out that all medications and supplements are compatible and if they are not, what you can do to avoid problems.

Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.

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