Wellness Refocused Education: Vitamins Part 1

When you hear the word supplements what do you think of first? Do you think of fish oil? Do you think of a multi-vitamin? Do think of protein powder? Do you think of steroids?

For the beginning few months of last year when I went back to school, I worked at Vitamin Shoppe. This gave me the opportunity to be around everything from apple cider vinegar to protein powder to BCAAs to fish oil to probiotics. Vitamin Shoppe is a really well rounded store if you’re looking for something to help fill in the gaps.

The store is divided into two sections.

When you walk through the front door, the left hand side was what you could consider lifestyle health. It had all of the vitamins and minerals, it had digestive aids like probiotics and enzymes. It also had greens powders and gender-specific care.

On the right hand side was where the sports nutrition lived. It was protein powder, fat burners, energy drinks, BCAAs, pre-workout products.

The middle of the store is where the tea, protein bars, beauty products lived.

While it was retail, Vitamin Shoppe doesn’t provide commission, so you can have an authentic conversion with customers about what their goals are and what they’re looking to buy to match those goals. They provided us with a lot of education about the products we were selling including information from studies published from the NIH for additional research. At the same time, I was just starting my health science courses and was reading everything I could about vitamins and minerals and how they cause specific functions in the body to occur. Timing couldn’t have been more perfect.

You could see the wheels turning as a customer decided which side of the store they needed. In some cases, we would have to introduce them to the other side of the store.

For many who trained hard, they typically went to the right, but every now and then we would get them to go to the left.

For a better conversation, there will be a few posts about supplementation.

We’re going to start with the left side of the store with vitamins.

First, there are 13 vitamins considered essential, just like essential amino acids, this means that the body must consume these through diet because it can only make a small amount of none at all (Thompson & Manore, 2015). If you have variety in your diet and have healthy functioning organ systems, you’re probably consuming enough of all of these vitamins through dietary means.

Individuals that have malabsorption disorders such as celiac disease are more likely to have deficiencies because of ability to absorb dietary fat. Individuals who also consume too little fat could be at risk as well. For better assistance to determine deficiencies, talk to you doctor and have a conversation about getting blood work done.

There are two kinds of vitamins:

  1. Fat soluble
    1. Vitamins A, D, E and K
  2. Water soluble
    1. Vitamin C and all B-vitamins

These two categories determines how a vitamin is absorbed, stored and then removed from the body.

Fat soluble vitamins need dietary fat to assist with transport and absorption (Thompson & Manore, 2015). They are also stored in adipose tissue (fat tissue), which means we don’t need to consume these every day. Since they can be stored in the body, consuming more than what is utilized can lead to toxicity. This occurs much more often when utilizing supplements, food rarely leads to toxic levels of fat soluble vitamins.

Toxicity of fat soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every fat soluble vitamin, but is a list of symptoms of all fat soluble vitamins.

  • fatigue
  • bone and joint pain
  • birth defects
  • nausea
  • diarrhea
  • liver damage
  • blurred vision
  • hair loss
  • skin disorders
  • hypercalcemia

Deficiency of fat soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every fat soluble vitamin, but is a list of symptoms of all fat soluble vitamins.

  • night blindness
  • impaired growth
  • impaired immunity
  • impaired reproductive function
  • osteomalacia or osteoporosis in adults
  • rickets in children
  • impairment of nerve, muscle and immune function
  • impaired blood clotting

Water soluble vitamins can be found in a larger variety of foods than fat soluble vitamins and are easily absorbed through the intestinal tract directly into the blood stream (Thompson & Manore, 2015). Our bodies don’t store water soluble vitamins, any excess is excreted in our urine after filtration from the kidneys. Since water soluble vitamins are removed through urine output it can be difficult to reach toxicity levels. It’s not impossible, but it’s not likely – at least through dietary consumption.

Toxicity of water soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every water soluble vitamin, but is a list of symptoms of all water soluble vitamins.

  • flushing
  • liver damage
  • blurred vision
  • glucose intolerance
  • nerve damage
  • nausea
  • diarrhea
  • nosebleeds
  • increased kidney stone formation

Deficiency of water soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every water soluble vitamin, but is a list of symptoms of all water soluble vitamins.

  • fatigue
  • decreased memory
  • confusion
  • muscle weakness
  • anemia
  • swollen mouth and/or throat
  • pellagra
  • vomiting
  • constipation
  • diarrhea
  • tingling and numbness of extremities
  • neural tube defects in a developing fetus
  • depression
  • fractures and bone pain
  • nerve damage

Some of the symptoms for both fat soluble and water soluble vitamins could be mistaken for other illnesses, but again to determine toxicity or deficiency for you as an individual, talk to your doctor.

This post is about fat soluble vitamins. We’ll get to water soluble a bit later, but now you know that there are two kinds of vitamins and what vitamins are categorized where.

fat soluble

So we have an idea of what fat soluble means, what is their purpose?

Fat soluble vitamins play an important role in specialized functions in the body by assisting complex systems.

Vitamin A is has multiple uses in the body, but Vitamin A isn’t just one compound. You may have heard of retinol, retinal or retinoic acid – these are different forms of it.

It’s required for eye functions. It assists our eyes in the ability to adjust to light changes, it also protects color vision.

During cellular development Vitamin A helps with cell differentiation, meaning it helps cells change their composition so they can each have different functions like hair growth or body growth.

In the reproductive system, Vitamin A helps with the production of sperm in men and fertilization in women as well as fetal development during pregnancy.

Vitamin A is important to the immune system (Stephensen, 2001). It assists innate immunity (the kind your born with) by allowing for the development of mucosal barriers and allow cells to work properly. In adaptive immunity it plays a role in developing T helper cells and B cell. A example of adaptive immunity would be developing antibodies after chicken pox exposure – you weren’t born with the chicken pox or the immune cells, but you adapted to the infection and developed them.

Vitamin D is best known for assisting with calcium absorption and helping keep bones strong. It also assists calcium with muscle contraction by allowing calcium to flow into muscle cells. If calcium levels are too low, normal contraction and relaxation can be inhibited with can lead to both skeletal muscle and cardiac muscle issues (Thompson & Manore, 2015). Vitamin D can help with the reduction of inflammation.

We can obtain Vitamin D when sunlight triggers synthesis in our skin (Office of Dietary Supplements, 2018). Individuals who live in regions that experience more darkness may not obtain enough through sunlight, but can obtain Vitamin D through food and if necessary through supplementation – but we’ll get to supplementation later.

Vitamin E is a name for a group of compounds with antioxidant properties.  Antioxidants protect cells from the effects of free radicals, which can lead to the development of cardiovascular disease and cancer (Office of Dietary Supplements, 2018). A free radical is an uncharged molecule and is highly reactive (Timberlake, 2018). Free radicals can be introduced to the body from the environment such as air pollution or ultraviolet radiation from the sun.

Vitamin E also works in the immune system and impacts T helper cells.

Vitamin K is less known, but not any less important. Similar to Vitamin E, Vitamin K is a name for a group of compounds that assist the body with blood clotting and bone metabolism (bone remodeling and growth). Healthy functioning individuals don’t typically need to worry about Vitamin K. However, individuals who take anticoagulants or have bleeding disorders will have Vitamin K levels assessed regularly to determine the need for supplementation.

The amount of Vitamin K recommended is so small that most diets in the United States meet minimum needs through diet (Office of Dietary Supplements, 2018). Vitamin K isn’t typically used in supplement form like other vitamins because the need is so small. In the case of individuals who have disorders that prevent proper absorption, a doctor may recommend a specific dosage.

Supplementation?

So, while deficiency and toxicity aren’t common, they can happen.

Toxicity is most common through supplementation, which is why it’s important to be careful when deciding to add a fat soluble supplement to your routine. While it may seem silly to consult your doctor on something of this nature, a quick phone call could assist with preliminary direction. Proper blood work will be able to assist in guiding the conversation.

A study published in 2015 examining adverse effects of supplementation found that supplements in general were the cause of over 23,000 emergency room visits per year (Geller, Shehab et al). The study was conducted over a 10-year period and researchers “defined “dietary supplements” as herbal or complementary products, and vitamin or amino acid micronutrients.”

A large concern with supplementation is toxicity, but quality of product and claims should also be on your radar.

Poor quality could lead to adverse effects and false claims can encourage individuals take products they don’t actually need. Supplements also are more likely to have a higher chance to interacting with prescription medications.

You will notice that labels on supplements ranging from vitamins and minerals to protein will say “these statements have not been evaluated by the Food and Drug Administration.” At the top of the latest consumer report on dietary supplements from the FDA, you will find the statement “The U.S. Food and Drug Administration (FDA) does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed.”

I think this approach protects the FDA and doesn’t fully look out for the consumer. They do have marketing regulations, which sets a baseline, but it also shows the holes and what companies are able to get away with too.

According to the NIH, it is the responsibility of manufacturers to have evidence of label claims, but they don’t need to provide them to the FDA prior to products going to market. Once on the market, these products will be monitored. A good example of product monitoring, while not vitamins – the protein claims for the Lenny and Larry Complete Cookies were found to be false. The cookies had varied amounts of protein, mostly under the claims. This led to the reformulation of the cookies. While this is an example of a food item, it’s also used for protein supplementation and can be found in health stores.

What foods can they be found in?

All of the these vitamins can be found through a diverse diet and since they can be stored in fatty tissue they don’t necessarily need to be consumed daily. Below are a few examples of foods that have these vitamins – it’s possible that you’re getting enough of them already.

fat vitamins

But what if my app tells me to?

Something to be mindful of – tracking applications. For those who track their food with a phone application like My Fitness Pal, be mindful of the information those applications report to you. The daily values (DV) are based on a 2,000 calorie diet and don’t always self-adjust to the calorie goals for individuals. Since there can be variance in the foods found in the database, they might not be 100% accurate. Lastly, deficiency and toxicity may happen over time, so if you believe you’re low or high with consumption of a vitamin one day, you may balance it out another day. Don’t supplement just because “My Fitness Pal told you to.” It’s a helpful tool for macronutrients, fiber and sodium, but I don’t believe the vitamin and other mineral amounts need to be monitored with it unless stated by a doctor.

While vitamins don’t work to provide you energy, they assist in the hundreds of reactions to keep you going allowing macronutrients to be broken down and utilized effectively.

Next time, we’ll talk about water soluble vitamins, what they do and where they can be found.

 

❤ Cristina

 

References

Geller, M.D., A. I., Shehab, Pharm D., MPH, N., Weidle, Pharm. D., N. J., & Lovegrove, MPH, M. C. (2015). Emergency Department Visits for Adverse Events Related to Dietary Supplements. The New England Journal of Medicine, 373:1531-1540.

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplements. Retrieved from Naational Institutes of Health: https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplements. Retrieved from National Institues of Health: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplments. Retrieved from National Institutes of Health: https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/#h7

Stephensen, C. (2001). Vitamin A, infection, and immune function. Annual Review of Nutrition, 21:167-92.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Timberlake, Karen. (2018). Chemistry: An introduction to general, organic and biological chemistry. New York: Pearson.

U.S. Food & Drug Administration. (2017). Dietary Supplements. Washington, DC: FDA.

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