May 3, 2006 -- Here are the answers to a selection of your questions on vitamin supplements, as provided by Dr. Lawrence D. Rosen, a New Jersey pediatrician and a founding member of the American Academy of Pediatrics Section on Integrative Medicine.
Mitri in Wilmington, N.C., asks: I give my kids a complete multivitamin every two days. Is it save for my kids? On the bottle it says "Pediatrician Recommended." Thank you for your time and kindness.
Answer: While I cannot discuss specific brands, in general, it is safe for most children to take a multivitamin product. We would love for all our kids to get their nutrients from a healthy, well-balanced whole foods diet, but that is sadly impractical for many families. Vitamins and minerals can be seen as insurance against deficiencies and, in some cases, as part of an optimal health plan. Try to find a brand with natural sweeteners, not tons of sugar or sugar substitutes, and check doses of specific nutrients like vitamin A with your pediatrician. As with all medicines, store them in a safe, secure location away from the reach of children.
Chris in Jackson, Tenn., asks: I have a 15-year old son who is a distance runner. There are several supplements that claim to help with endurance and vo2 max. My basic question is, are there any supplements that are safe and work? Thank you
Answer: The safest plan to help our children thrive is based on lifestyle -- healthy foods, proper amount of sleep and exercise. The best kind of protein is found in healthy lean meats or vegetable sources. The American Academy of Pediatrics does not recommend any supplements for use by children under 18 for the purpose of fitness or body building or weight control. There may pose specific dangers to the kidneys, liver and heart caused by components of these supplements. Some have been found to be tainted with steroids and others with dangerous amounts of ephedra, an herbal stimulant.
Misti in Georgia asks: I give my 7-year old daughter an herbal supplement of Melatonin, 3 mg to help her sleep at night. Her pediatrician recommended it because of her inability to fall asleep due to the side effects of an additional medication she takes, Focalin xr. I often worry about giving her this, but her doctor assured me it was fine. Without it, she stays up until midnight or later. What is your opinion on the safety of this for long-term use?
Answer: Melatonin is a neurohormone found naturally in our bodies, and it regulates sleep-wake cycles. Certain children (those with ADHD for example) may be deficient in melatonin, and synthetic sources given orally may be helpful for those children to combat sleep difficulties (Weiss M, et al: "Sleep Hygiene and Melatonin Treatment for Children and Adolescents With ADHD and Initial Insomnia." J Am Acad Child Adolesc Psychiatry. 2006 Mar 10). Whenever working with natural health products, especially in combination with a prescription medicine, consult with a health care provider who can guide you as to proper use of the supplement.
Sonia in Knoxville, Tenn., asks: I have a daughter who is a healthy 14-year old, 5 feet 5 inches, weighing approximately 96 pounds. She eats fairly well, I don't keep junk food in the house nor sodas. I have thought of supplements to try to have her gain some weight. Should I? Or should I just let nature take it's course.
Answer: Figuring out what weight is appropriate for what height is a tricky business, and it depends on genetics and body type. The most important thing is to eat a well-balanced diet rich in healthy proteins, fats and carbohydrates. Your daughter may not need to gain weight, and you run the risk of creating or exacerbating an eating disorder by making weight gain an important focus. As long as she's healthy, check with your primary health care provider and let her grow naturally.
Bruce in Portland, Ore., asks: Given the cautionary position in ABC News' story about vitamins and supplements, please give us some overall guidelines for safe use of those vitamins and supplements that can pose problems high levels, such as vitamin A and calcium. I am an adult male, 60 years old.
Answer: Generally, safe doses for vitamins and minerals have been established and are called Dietary Reference Intakes (http://iom.edu/?id=24855), formerly known as RDAs or Recommended Daily Allowances. These levels, however, only stipulate what is needed to avoid deficiencies and major health problems, like scurvy or rickets. What is not known is what the ideal level of each nutrient is for each person for optimal health. Check with your primary health care provider to discuss your own specific needs.
Paul in Costa Mesa, Calif., asks: I believe your news program tonight referred to an increased risk of congestive heart failure from vitamin E. Could you explain, or clarify, please?
Answer: Vitamin E is an antioxidant found in foods including certain seeds, nuts, oils and vegetables. There is not just one kind of vitamin E; nutritional experts generally recommend a mixture of four types of tocopherols and tocotrienols, which make up the whole vitamin E complex. Some studies have indicated that doses at or above 400 IUs may increase the risk of heart failure, but in many of those studies, patients were already at high risk with pre-existing heart disease or diabetes. What is not known, again, is the ideal dose of what type of vitamin E for each person.
Tanya in Nebraska asks: How do you know if you are taking too much of one vitamin?
Answer: There is such a thing as taking too much of a vitamin. Some vitamins, such as vitamin A, can cause obvious symptoms, such as headaches, when dosing is too high, and doctors can measure blood levels to check this. Some vitamins, though, can cause internal metabolic problems that won't be obvious until much later -- as always, check with your primary health care provider to review all vitamins and supplements. A good general list of vitamin side effects can be found at http://www.emedicine.com/EMERG/topic638.htm
Suzanne in California asks: Is there any way to know what vitamins my body needs?
Answer: While some laboratories market specialized tests to evaluate vitamin levels, there is still no perfect way to measure exactly what each person needs. Blood tests for some vitamins, like A and D, may be helpful to see if you're deficient or toxic, but these tests do not reliably measure what is optimal for your body. Depending on your genetics, environment and general health, you have specific needs that are different from others' needs.
Nancy in Oklahoma asks: I take a lot of supplements, like calcium, vitamin E, vitamin C, and I also take vytorin, toprol xl, Evista, Dicylomine, which are prescribed for me. Would the supplements I take interfere with the other medications?
Answer: Any supplement can interfere with any prescribed medication. This is true of herbal products as well as nutritional supplements. Just because something is natural does not mean it's safe. Some vitamins, for example, can affect your body's ability to clot blood, and may block or enhance the effect of one of your prescription medicines. You should take this opportunity to discuss your supplement regimen with your primary health care provider.
Jamie in Florida asks: Are vitamin waters safe to drink, and do we need to worry about mixing certain types?
Answer: As Dr. David Katz reported for ABC News previously (abcnews.go.com/GMA/OnCall/story?id=969246), most of us do not need the additives put in high-priced, specialized vitamin waters. Many of these drinks contain large amounts of sugar and salt with minuscule doses of vitamins, and you are probably better served by drinking plain water. Since these vitamin sources are not regulated as medicines, but as food, there is no way to know what, if any, health benefit or harm may result from drinking them.
Alex in Brentwood, Calif., asks: I just started taking Juice Plus brand vitamins. They are all natural, 17 fruits and vegetables. Are these natural vitamins better than the manufactured kind? Thanks!
Answer: Juice Plus is one of several brands of fruits-and-vegetables-in-a-pill or in a powder. The theory is grand -- we all need several servings of fruits and veggies a day, and it's quicker and easier to pop the pill than eat the food. Even if these supplements contained fresh, organic produce, it would still be better for you to eat the actual, whole foods. It is unlikely that your body absorbs the healthy nutrients from vitamins the same way it does from actual foods. If used, vitamins should be viewed as insurance policies against deficiencies and as tools to promote optimal health, not as a replacements for good, healthy eating.