Make Informed Health Care Choices
If you choose to use vitamin, mineral, or herbal supplements, make well informed decisions and select quality products. Your health may depend on it.

Nutritional supplements are a reliable source of essential daily nutrients for many people. They should compliment your diet and health care choices. A nutritious well balanced diet is also necessary for optimal health, supplements can not provide the over 40 nutrients and other dietary elements the body requires.

Many Americans use nutritional supplements for general wellness, prevention or medical purposes. A 1997 survey of 43,000 U.S. households showed that 68% used vitamin, mineral or herbal supplements in the past six months, with nearly 90% of these using two or more products (source: Hartman & New Hope). Supplements and their benefits are being more widely recognized by consumers, scientist and physicians as an integral part of our health care. However, the lack of definitive research, medical guidelines, and government regulation warrants caution for some supplements.

Research continues to accumulate supporting the role of nutrients in promoting optimal health, energy, vitality, immune system functions, disease prevention and treatment. However, the specific medical function and proper amount for many nutrients has not been scientifically determined or clinically tested using double blind studies. Therefore, choosing vitamin, mineral and herbal supplementation for therapeutic purposes is often a personal decision based on personal experiences, traditional remedies, preliminary studies, media articles, or advertisements. For helpful information, explore our HealthMax web site and consult you health care professional for medical advice. For a general overview of nutrition, supplementation, and the dietary supplement industry, the following organizations have published information from their perspectives.

• The Council For Responsible Nutrition [www.crnusa.org/ben_exec.htm] provides a supportive and informative view of supplementation.
  
• National Institute of Health, Office of Alternative Medicine [ altmed.od.nih.gov/oam/what-is-cam/fields/diet.shtml] provides a brief overview of potential diet and nutrient influences on chronic disease.
  
• The American Dietetics Association's position paper [www.eatright.org/asupple.html] offers a cautious and conservative view of supplementation.
  
• The FDA's guide to dietary supplements [vm.cfsan.fda.gov/~dms/fdsupp.html] provides a regulatory perspective of the supplement industry.

Who May Need Supplements?
Personal and professional opinions vary on who should take supplements. However, if you are not obtaining the Recommended Daily Allowance or your personal nutrient requirements through your diet, then supplements may be appropriate. A government survey of 21,000 people showed that not a single person obtained 100% or the RDA for each of 10 nutrients. Considering the typical American diet does not provide adequate levels of 13 essential vitamins and minerals (A, C, E, thiamin, riboflavin, B-6, B-12, folic acid, calcium, iron, magnesium, selenium, and zinc), a premium multivitamin and other supplements may be necessary to fill this gap.

Supplementation may be helpful for the following people.
Adults and teenagers with busy lifestyles not eating regular healthful meals, including breakfast.
Dieters often fall short on nutrients such as vitamins B-1, B-6, B-12, folic acid, calcium, iron, zinc, and magnesium (1). Low fat diets may not meet the recommended level for vitamin E (1)
Physically active people not properly balancing their diets. Regular exercise may require additional antioxidants and minerals. (3)
Athletes in a physical training program require a significant increase in nutrients for sustained strenuous activity.
Baby boomers, as we age additional amounts of vitamins D, B-6, B-12 and calcium may be required due to changes in our systems (1).
Elderly people may have lower levels of folate, calcium, and vitamins B-12 and D. Changes in digestion, biochemistry, and eating habits can result in not eating properly or not absorbing nutrients efficiently. For example, difficulty eating or digesting grains and nuts could cause concerns such as not getting enough vitamin E.
Pregnant or breast feeding women need more of certain nutrients, especially iron, folic acid and calcium (4). Pre-natal supplements containing at least 400 mcg of folic acid are recommended prior to and during the early weeks of pregnancy. (1) Generally, women should avoid herbal supplements while pregnant unless under a physician's advice.
Women with excessive menstrual bleeding may need to take iron supplements.(4)
Women using oral contraceptives can have interference with their metabolism of vitamins, minerals, and amino acids. (5)
Vegetarians may not receive adequate calcium, iron, zinc and vitamin B-12. (4)
People not able to drink milk or eat dairy products may not get sufficient calcium and vitamin D.
People with certain disorders or diseases may require higher nutrient levels due to interference with nutrient digestion, absorption, metabolism or excretion. (4) For example, gastrointestinal disorders such as colitis and irritable bowel syndrome can significantly reduce nutrient absorption.
People taking certain over-the-counter and prescription drugs that interfere with metabolism and absorption of vitamins and minerals (2)
Patients advised by their physician to compliment conventional medical care or special modified diets
People choosing alternative or complementary health care treatment
Smokers may require more vitamins and minerals, such as vitamin C (1)
Heavy alcohol drinkers, consumption interferes with the body's ability to absorb and use the B complex vitamins and other nutrients (1)
People exposed to chemicals in the air and water that deplete nutrients in the body. (3) Chemical pollutants in urban areas can contain toxins that destroy nutrients or cause the body to use up enormous amounts of nutrients.
People eating foods that are processed, commercially grown in nutrient deficient soil, or picked before they are fully ripe may not be obtaining all the nutrient value they expect.
People choosing extra nutrient levels for added protection against certain diseases (e.g. some cancers, heart disease, osteoporosis, cataracts, etc.)

Consult your health care professional for all medical advice. Some supplements may not be appropriate with certain medical conditions or medicines.

Sources:
(1) Council For Responsible Nutrition - Vitamin Supplements and You
(2) Council For Responsible Nutrition - A Guide to Using Vitamin Supplements
(3) Douglas Labs - Multivitamins brochure
(4) University of Nebraska - www.ianr.unl.edu/pubs/NEBFACTS/NF92-90.HTM
(5) Advanced Physician Products www.approducts.com/supplements

Safety
Natural supplements have been used by many people for many years, with few incidences of health concern. A healthy body can usually regulate the absorption or elimination of nutrients, however, some nutrients can be toxic in large excessive amounts (see Toxicity and Risks). Herbs and other natural substances have been used historically for medicinal purposes, are used by health care professionals in many other countries, and are the active ingredients in many of our modern pharmaceuticals. However, there are no federal standards to ensure safety, purity, proper dosage, and quality manufacturing practices. The Food and Drug Administration is not required to test or approve supplements ingredients and products before they are marketed. Therefore, always use caution to select quality premium products and follow directions carefully. Not all supplements are created equal.

Consult Your Health Care Professional
Your physician should be consulted for all medical advice and before the use of nutritional supplements to compliment other medical care. It is especially important that you seek medical advice regarding supplementation if you are pregnant, breastfeeding, taking prescription or over-the-counter medicines, chronically ill, or integrating supplements with other medical treatments. In some situations, supplementation should be clinically managed by your physician. Many physicians recommend nutritional supplements for preventive and therapeutic use. If your physician is not familiar with natural supplements, they may be able to recommend an alternative provider.

Many naturopaths, acupuncturist, chiropractors, herbalists, and other providers are also a credible source for determining appropriate supplementation and alternative treatments. A dietician can assist with certain dietary issues.