I'm sure you'll agree that, as a mother, it's extremely hard to decide whether you should give any supplements to your family – let alone pick which ones!

With all the confusing information out there, how is a MamaDoctor supposed to make sense of it all?

I feel you! I had a hard time figuring it out too.

So I worked with our team of authors and doctors to gather all the best possible evidence and most trusted resources – and in this post, I'd like to share them with you.

Vitamin Supplements

Vitamins are crucial for optimal human functioning.

Vitamins fulfill functions like converting food into energy, keeping bones strong, supporting the immune system, aiding digestion, protecting against infections and more.

We normally get most of our vitamins and minerals from the food we eat. However, we can also get them through supplements. People supplement their intake if they have a shortage of it in their diet, or if they show symptoms of a deficiency.

Let me start by saying that despite 90% of the general public thinking that taking vitamins is a good idea, a recent important study has found we're not getting much benefit from taking either specific vitamin supplements or multivitamins.

This is not new information for those familiar with the research, and the American Academy of Pediatrics has clearly said over the years that children receiving a normal, well-balanced diet do not need vitamin supplementation.

Below is a list of foods that are great sources for vitamins. Some, like fortified milks, are added specific vitamins.

Vitamins in Different Foods

Foods	Vitamins
Limes	vitamin C
Milk (fortified)	vitamin D, protein, calcium
Yogurt (fortified)	vitamin D, calcium
Almond milk (fortified)	vitamin D, calcium, protein
White rice	carbohydrates, protein, minerals
Zucchini	protein, vitamin A, C, B1, B3, B6, K, and minerals
Potatoes	vitamin C, B6, potassium
Cannabis	Hemp seeds contain protein, omega 3, 6 and 9 fatty acids
Purple grapes	vitamin C, K, B2, B6, and many minerals and antioxidants
Bananas	vitamin C, B, A, B2, B3, B6, potassium and other minerals
Olive oil	high in healthy fats: monounsaturated fat; omega-6, omega 3, vitamin E and K
Beets	vitamin C, B6, B9, and loads of minerals

The AAP does however recommend that children receive an appropriate amount of Vitamin D, which is not always easy to assess unless you take a blood sample.

In addition, if you – like me- opt for a mostly plant-based diet, you might need to supplement your diet with Vitamin B12.

So, you might be wondering “When would I benefit from a vitamin supplement?”

Prenatal Vitamins

Prenatal vitamins are supplements that contain vitamins and minerals that women take during pregnancy. They usually contain folic acid, other vitamins, and minerals including iron, iodine, and calcium.

Benefits of prenatal vitamins while pregnant 

Prenatal vitamins contain many vitamins and minerals that may be missing in a pregnant woman’s diet and which are essential for her own and her baby’s health.

Folate/folic acid

Folate, the essential vitamin sometimes referred to as Vitamin B9, is the most important vitamin to take when planning a pregnancy.

Folate is more commonly known as “folic acid” – the synthetic supplemental form of folate.
Folic acid is known as the ‘pregnancy supplement‘ and women who are planning a pregnancy often take folic acid on a daily basis. Folic acid is essential for the growth of the fetus.

Prenatal vitamins and birth defects

Taking folic acid prevents birth defects of the brain and spine. Called neural tube defects (NTDs), these defects are caused when the fetus doesn’t receive adequate folate when its neural tube is being formed.

Research has shown that taking folic acid before getting pregnant and in early pregnancy lowers the risk of having a baby with certain birth defects.

The Mayo Clinic suggests looking for a prenatal vitamin that contains: folic acid, calcium, iron and vitamin D. They also recommend including vitamin C, vitamin A, vitamin E, zinc, iodine and suggests copper might also be beneficial.

Do you have to take prenatal vitamins when pregnant and are they really necessary?

Evidence strongly supports the use of folic acid supplements before pregnancy and during the first trimester. Multivitamins routine supplementation isn't supported by good evidence,  but there is no good reason not to use them.

Researchers found evidence to support routine folic acid supplementation but not supplementation of omega-3 fatty acids, vitamin D, or iron.

The research found evidence that it’s harmful to take supplementation with large doses of vitamins A, C, and E.

The research authors recommend that pregnant women should stick to the nationally advised folic acid and vitamin D supplements. What’s really essential, is eating healthy foods before and during pregnancy.

What to do if your prenatal vitamins make you sick

In this case, you can consider taking your prenatal vitamin with a snack or before you go to bed at night.

Should I take prenatal vitamins to help my hair grow?

Prenatal vitamins are formulated specifically for women who are pregnant or trying to become pregnant, and women who are breastfeeding. They are not formulated to stimulate hair growth and there is no scientific proof that they do.

Will prenatal vitamins help you lose weight?

This is one more misconception regarding prenatal vitamins. Some people claim that these vitamins will stimulate your hair to grow thicker, make your skin appear clearer and even help you lose weight. None of these claims are scientifically proven.

Is it okay to take a prenatal vitamin when not pregnant?

You will probably not come to any harm, but you will also not benefit by taking prenatal vitamins when you’re not pregnant. The Mayo Clinic advises against taking prenatal vitamins if you’re not pregnant.

Best Vitamins for Different Situations

Nail growth

While many vitamins are promoted for strengthening nails and helping them to grow faster, scientific evidence is lacking.

Research has shown that brittle nails benefit from a 2.5-mg dose of biotin daily or a 10-mg dose of silicon daily. Treatment with biotin for brittle nails also showed positive results in another study.

Thick healthy hair

Hair thickness is largely genetic, so there is only so much that nutrients can do to increase the thickness of individual hair.

Hair that is thin because of malnutrition will react positively to supplements to help it grow. The hair of a person who follows a nutrient-rich diet won’t benefit from a supplement.

Gingivitis

Gingivitis is an inflammation of the gums, usually caused by a bacterial infection. The infection is most likely due to poor dental hygiene and genetic predisposition, but sometimes it can be linked to a lack of vitamin C in your diet. Foods rich in vitamin C strengthen the immune system and can help fight off the gum infections.

Liver functions

The liver is a very important organ, responsible for storing and releasing energy from foods and detoxifying the body.

Liver supplements often claim that they will “detoxify” and “rejuvenate” the liver, but these supplements don’t work?

The herbal ingredient, milk thistle, has been used for ages to treat liver problems and is a popular ingredient in liver supplements.

This study found that children who were being treated with chemotherapy for leukemia and who also received milk thistle supplements had fewer signs of damage to their liver. But a review that evaluated 18 milk thistle studies found the supplement wasn’t very effective.

Skin

Your skin is your largest organ and it needs a whole slew of vitamins to stay healthy: vitamin D, C, E, and K. A multivitamin that contains all of these will be your best option if you don’t follow a healthy diet that includes vegetables and fruit.

Circles under the eyes

A retinol cream may be useful. Retinol is related to vitamin A. It is sold as a cream, a gel, or in liquid form.

Retinol help clears up bags under the eyes because it counteracts collagen deficiency. Collagen connects tissues.

Brain function

This is a controversial issue. B vitamins, antioxidants, vitamin C and ginkgo biloba are touted as being beneficial, but experts say there is no data on whether they are safe or actually do anything to help.

Joint pain

Vitamin D supplements may treat joint pain in people who have a vitamin D deficiency. However, people who have joint pain, but don’t have a vitamin D deficiency shouldn’t take supplements for joint pain.

Vegetarians

Strict vegetarians that exclude all animal products from their diets must take a vitamin B12 supplement.

Acne

For acne, vitamin A can be used, but not as a supplement. It must be applied to the skin in the form of a lotion. Most topical medications (lotions) contain the vitamin in the form of a retinoid, which helps to regenerate the skin.

It’s important to remember that skin is not likely to benefit from vitamin A if you’re not deficient in the nutrient.

Infants

Breast milk is the very best for babies. However, new research has found that children who were breastfed and did not take supplements, particularly those breastfed more than 1 year, should receive a vitamin D supplement.

Toddlers

The Mayo Clinic doesn’t advise vitamins for toddlers, saying that food is the best source of nutrients. Even toddlers who are picky eaters probably get enough vitamins in through foods like breakfast cereal, milk and orange juice, which are fortified with vitamins and minerals.

Teenage girls

First, there is no difference in the nutrient needs of boys and girls. Second, teenagers don’t need their own vitamin.

There are a lot of companies that claim the supplements are necessary for teenagers, but there’s very little research to support this claim.

One study on the subject found that teenagers who do take multivitamins are also living a healthy lifestyle. For instance, the researchers found that teenagers who take multivitamins also follow a healthy diet.

It is best to establish a healthy eating habit from a young age. This will provide all the nutrients a child needs.

How Should You Take Vitamin Supplements?

This depends on the type you’re taking. Some vitamins should be taken after a meal, while others should be taken on an empty stomach.

Prenatal vitamins – Prenatal vitamins are multivitamins and are best taken before lunch.

Fat-soluble vitamins – These include vitamin A, vitamin K, vitamin E, and vitamin D. They are best taken with dinner.

Water-soluble vitamins – Vitamin C, all B vitamins, and folate (folic acid) are water soluble. Take them on an empty stomach a half an hour before breakfast.

What Diseases/Symptoms do Different Vitamins Deficiency Cause?

Symptoms of vitamin A deficiency

The following symptoms may be a sign of vitamin A deficiency: dry skin and dry eyes; night blindness; fertility issues; frequent throat and chest infections; poor wound healing; acne and stunted growth in children.

Symptoms of vitamin C deficiency

Common signs of low levels of vitamin C include dry, wrinkled skin; bleeding, swollen gums; easy bruising; slow wound healing and frequent nosebleeds; increased risk of infections due to a compromised immune system; fatigue and irritability.

These symptoms can also be caused by other factors, though.

Vitamin B12

Vitamin B12 is a water-soluble nutrient that the body needs in small amounts to function and stay healthy. Vitamin B12 is also known as cobalamin.

What Does Vitamin B12 do for Your Body?

Vitamin B12 helps to make red blood cells, DNA, RNA, energy, and tissues and keeps nerve cells healthy. Your body needs a daily supply of this nutrient to make enough red blood cells and keep your nervous system working.

The B12 vitamin is crucial to the normal function of the brain and the nervous system.

The metabolism of every cell in the body depends on B12 because B12 is crucial for the synthesis of fatty acids and energy production. Vitamin B12 enables the release of energy by helping the human body to absorb folic acid.

Your body produces millions of red blood cells every minute. These cells need B12 to multiply properly. If B12 levels are too low, enough red blood cells can’t be produced and anemia can be the result.

Normal Vitamin B12 Levels

How do you know if you are getting in enough vitamin B12? You can get a blood test done and compare your test result with recommended levels.

A normal (non-vegetarian) diet provides 5-7 mcg (micrograms) of vitamin B12 per day. This amount is more than enough to maintain needed levels.

According to the NIH, the recommended dietary allowance (RDA) is 2.4mcg/day after 14 years of age, and 2.6mcg/day for pregnant women.

Recommended Dietary Allowances for Vitamin B12

Age	Male	Female	Pregnancy	Lactation
0–6 months*	0.4 mcg	0.4 mcg
7–12 months*	0.5 mcg	0.5 mcg
1–3 years	0.9 mcg	0.9 mcg
4–8 years	1.2 mcg	1.2 mcg
9–13 years	1.8 mcg	1.8 mcg
14+ years	2.4 mcg	2.4 mcg	2.6 mcg	2.6 mcg
* Adequate Intake

The body can store Vitamin B12 for years in the liver. This means that a deficiency is the result of too little intake over many years. The body can store 2-5 milligrams.

You won’t develop a B12 deficiency if you don’t take B12 in for a day, a week or even a month or more.

 

Vitamin B12 Deficiency

Vitamin B12 deficiency develops over a long time.

How do you test for the deficiency? A blood sample will be drawn from a vein in your arm. A test measure the concentration of folate and vitamin B12 in the serum or plasma (liquid portion of the blood).

The amount of folate inside the red blood cell may also be measured.

It can be difficult to establish a person’s B12 status because folic acid can mask B12 deficiency. So, if a person takes a folic acid supplement, a blood test might not spot a B12 deficiency.

The deficiency might only be picked up once the person experiences serious health problems.

Why do You Get Vitamin B12 Deficiency? Why Does Vitamin B12 Deficiency Cause Anemia?

Diet

We get B12 from the food in our diet that is from animal origin. B12 is naturally present in liver, clams, beef, fish, milk, and eggs. People who don’t eat these foods can develop B12 deficiency.

A strict vegetarian diet like the vegan diet excludes all animal products. People who follow this diet have been shown to develop B12 deficiency.

Vegetarian diets that include milk products provide B12, so deficiency is unlikely in these diets.

Malabsorption – B12 deficiency is also caused by malabsorption and leads to anemia. People who have pernicious anemia can't absorb enough vitamin B12 from food.

They can’t absorb enough B12 from food because they lack intrinsic factor, a protein made in the stomach. A lack of this protein leads to vitamin B12 deficiency.

Pernicious anemia is a condition in which the body can't make enough healthy red blood cells because it doesn't have enough vitamin B12.

B12 deficiency can also occur in certain medical conditions like untreated celiac disease and Crohn’s disease.

Age

People also become deficient in B12 as they get older. It is estimated that 10% to 15% of individuals over the age of 60 years may suffer from B12 deficiency.

Medications

Certain medications may also affect your vitamin B12 levels. This includes drugs to help treat gastroesophageal reflux disease (GERD).

Proton-pump inhibitors which are used to treat GERD, reduce the amount of acid in the stomach, which is needed for food to release B12 – so less acid, less B12.

Infants

Pregnant and lactating mothers who follow a strict vegetarian diet and their infants are at risk of vitamin B12 deficiency.

Vitamin B12 crosses the placenta during pregnancy and is present in breast milk.

Babies who are breastfed by mothers who eat no animal products may have very limited reserves of vitamin B12. They can develop vitamin B12 deficiency within months of birth.

If the deficiency is not detected and not treated it can result in severe and permanent neurological damage for infants.

How do You Know That Your B12 Levels are Too Low?

One or more of these symptoms could indicate that your vitamin B12 levels are too low.

Symptoms of vitamin B12 deficiency

Low levels of B12 have been linked to nerve damage which can have different outcomes: damage to the optical nerve that impairs vision; a disturbance of mobility and balance; sensations of pins and needles.

B12 deficiency has also been indicated in mood and brain disorders like depression and dementia; extreme weakness and fatigue; a red and swollen tongue; anemia that leads to breathlessness and dizziness.

What Does a Lack of B12 Do to the Body?

Lack of vitamin B12 can cause serious anemia, nerve damage and degeneration of the spinal cord.

Why does vitamin B12 deficiency cause neuropathy – damaged nerve cells?

B12 deficiency affects the nervous system in the following way. It damages the myelin sheath that surrounds and protect nerves.

Without this protection, nerves cannot function properly and conditions such as peripheral neuropathy occur. In other words, your peripheral nerves don’t function properly because they're damaged.

Even a relatively mild deficiency may affect the nervous system and restrict the proper functioning of the brain.

If the nerve damage caused by a lack of B12 is severe and is not treated, it may cause permanent damage to the nerves.

One study found that poor vitamin B12 status is a potential risk factor for brain atrophy (shrinkage of the brain) and may contribute to poor cognitive function.

Neuropsychiatric Disorders as a Result of Vitamin B12 Deficiency

Low levels of B12 can lead to psychiatric symptoms such as depression, anxiety, fatigue, and even psychosis.

A severe vitamin B12 deficiency can lead to deep depression, paranoia and delusions, memory loss, incontinence, loss of taste and smell, and more.

From Which Food Do We Get Vitamin B12?

Normal non-vegetarian diet

Diets that include animal products are rich in B12. B12 is naturally present in foods of animal origin: liver, clams, oysters, beef, fish and dairy products like eggs milk, cheese, and yogurt. Some packaged foods like cereals are also fortified with B12.

Vegetarian sources of vitamin B12

Plant foods do not produce vitamin B-12. According to one study, seaweed and mushrooms contain vitamin B12 analogs that are inactive in humans.

However, another study found that nori, (Japanese seaweed) which is formed into a sheet and dried, is the most suitable Vitamin B12 source for vegetarians.

The same study found that purple laver (also a type of seaweed) is a good source of vitamin B12 for vegetarians.

The study found relatively high levels of Vitamin B12 in shiitake mushrooms but noted that these levels can vary considerably. Also, vitamin B12 in mushrooms is much lower than that found in dried purple laver.

Plant milk like soy milk, almond milk, coconut milk, and rice milk don’t naturally contain B12 and must be fortified with vitamin B12. If you rely on these sources for vitamin B12, you must check the product label to ensure it is fortified with vitamin B12.

The Harvard Medical School lists the following as the best foods for vitamin B intake.

Selected Food Sources of Vitamin B12

Food	Micrograms (mcg) per serving	Percent DV*
Clams, cooked, 3 ounces	84.1	1,402
Liver, beef, cooked, 3 ounces	70.7	1,178
Breakfast cereals, fortified with 100% of the DV for vitamin B12, 1 serving	6.0	100
Trout, rainbow, wild, cooked, 3 ounces	5.4	90
Salmon, sockeye, cooked, 3 ounces	4.8	80
Trout, rainbow, farmed, cooked, 3 ounces	3.5	58
Tuna fish, light, canned in water, 3 ounces	2.5	42
Cheeseburger, double patty and bun, 1 sandwich	2.1	35
Haddock, cooked, 3 ounces	1.8	30
Breakfast cereals, fortified with 25% of the DV for vitamin B12, 1 serving	1.5	25
Beef, top sirloin, broiled, 3 ounces	1.4	23
Milk, low-fat, 1 cup	1.2	18
Yogurt, fruit, low-fat, 8 ounces	1.1	18
Cheese, Swiss, 1 ounce	0.9	15
Beef taco, 1 soft taco	0.9	15
Ham, cured, roasted, 3 ounces	0.6	10
Egg, whole, hard boiled, 1 large	0.6	10
Chicken, breast meat, roasted, 3 ounces	0.3	5
*DV = Daily Value

What Foods Contain Vitamin B12 and Folate (also called vitamin B9)?

There is no food that contains both.

B12 is derived from animal products while folate is derived from plants, including fruits and vegetables, whole grains, beans, breakfast cereals, and fortified grains and grain products.

A lot of food is fortified with folic acid, which is the synthetic form of folate.

Vitamin B12 as a Dietary Supplement

Supplements can prevent and treat vitamin B12 deficiency.

The Adventist Health Study-2 looked at the diets of 96,000 Seventh-day Adventists in the U.S. and Canada. These total vegetarians, the study found, have a lower risk than other Americans of heart disease, several cancers, high blood pressure, arthritis, and diabetes.

However, total vegetarians are more likely to be at risk of nutritional deficiencies like a lack of calcium and vitamin B12.

The subjects in the Adventist Health Study did not show significant numbers of vitamin B12 deficiency because they were supplementing their diets with vitamin B12-fortified foods or B12 supplements.

How to Take Vitamin B12 Supplements

A daily dose of supplementation of vitamin B12 tends to be around 1,000mcg (1mg). Although oral absorption is limited to about 1%, it still means that 10mcg is absorbed. This is adequate for daily requirements and to replace B12 levels gradually.

You can get vitamin B12 as an oral supplement and through intramuscular injections as well as sublingual (under the tongue), in the form of wafers, and intranasal administration is also available.

As a general rule, most people take oral supplementation.

Why do we get B12 injections?

B12 injections are usually recommended if you have a serious deficiency.

Injections are also preferred for people who have gastrointestinal problems and older adults who have low levels of stomach acid or intrinsic factor. This is because B12 shots bypass the stomach so the vitamin B12 is absorbed directly into the bloodstream.

A medical professional must administer the injections, but this is not done on a daily basis. Oral supplements are taken on a daily basis.

You can also supplement your B12 intake with a multivitamin. Most typical multivitamins contain 6mcg, which provides more than enough B12.

Vitamin B12 shot reactions

The risk of toxicity or overdose is of vitamin B-12 because extremely low.

However, there may be mild side effects, including pain, redness, or itching at the site of the injection, mild diarrhea, and a swelling sensation in the body.

More serious side effects, which require immediate medical attention, include muscle cramps, irregular heartbeat, unusual weakness or tiredness, swelling of the ankles or feet.

Severe reactions are very rare but require emergency intervention. These include itching and swelling of the face, throat, or tongue, breathing difficulties, severe dizziness, sudden vision changes, and slurred speech.

Does Vitamin B12 Help With Energy Levels?

There are many claims that vitamin B12 is a major energy booster. One of the symptoms of B12 deficiency is fatigue so it is reasonable to expect that if you take B12 supplements, it would boost your energy levels.

However, B12 supplements won’t give you a sudden “boost” of energy as replacement of the vitamin and recovery from deficiency takes time.

Vitamin D

Vitamin D is a fat-soluble essential vitamin that our skin synthesizes when exposed to the sun. It is produced internally when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis.

Vitamin D comes in two forms. Vitamin D2, also known as ergocalciferol, is obtained from dietary vegetable sources and oral supplements.

Vitamin D3, also known as cholecalciferol, is obtained primarily from skin exposure to ultraviolet (UVB) radiation in sunlight and food like oily fish and fortified foods (milk, juices, margarine, yogurts, cereals, and soy), and oral supplements.

How much vitamin D do you get from an hour in the sun? That depends on the latitude you are at, your skin color and the strength of the sun’s UV rays at the time.

Vitamin D functions as a hormone, and every cell in the body has a receptor for it.

It's difficult for people to get the recommended amount of vitamin D from food alone. We need sunlight for optimal vitamin D levels.

People who don’t get enough sunlight should consume drinks and food fortified with vitamin D or should take supplements.

Midday, especially during summer, is the best time to get sunlight. At that time the sun is at its highest point and the UVB rays are most intense. This means one needs less time in the sun to produce enough vitamin D.

One study found that 13 minutes of exposure to midday sunlight during summer three times per week was enough to produce healthy levels of vitamin D among Caucasian adults in the UK.

Over a billion people worldwide could be vitamin D deficient or insufficient.

Below are some foods rich in vitamin D (naturally or fortified):

Selected Food Sources of Vitamin D

Food	IUs per serving*	Percent DV**
Cod liver oil, 1 tablespoon	1,360	340
Swordfish, cooked, 3 ounces	566	142
Salmon (sockeye), cooked, 3 ounces	447	112
Tuna fish, canned in water, drained, 3 ounces	154	39
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies)	137	34
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup	115-124	29-31
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV)	80	20
Margarine, fortified, 1 tablespoon	60	15
Sardines, canned in oil, drained, 2 sardines	46	12
Liver, beef, cooked, 3 ounces	42	11
Egg, 1 large (vitamin D is found in yolk)	41	10
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)	40	10
Cheese, Swiss, 1 ounce	6	2
* IUs = International Units. ** DV = Daily Value.

What Does Vitamin D Do for Your Body?

Enough vitamin D is necessary to maintain healthy bones and teeth; it may also protect against a range of conditions such as cancer, type 1 diabetes, and multiple sclerosis.

How does vitamin D help to build strong bones and teeth?

Vitamin D helps the body to absorb calcium and phosphorus from the food that we eat, which build strong bones and teeth.

Normal Vitamin D Levels

Healthy range

Vitamin D intake can be measured in two ways: in micrograms (mcg) and International Units (IU).

The recommended daily allowance for Vitamin D is currently set at 400-800IU/day, but many experts say that this is too low for adults.

In the UK, the NHS recommends that children from the age of one year and adults must get 10mcg of vitamin D a day. This includes pregnant and breastfeeding women and people at risk of vitamin D deficiency.

The NIH recommends 600 IU of vitamin D daily for all ages up to 70 and 800 IU for 71 and older. The recommendation is based on the premise that most people don’t get enough sunlight.

The safe upper limit has been increased from 2,000 to 4,000 IU per day. Some researchers suggest that the safe upper limit could be as high as 10,000IU/day.
You can get this amount through a supplement, but most multivitamins have too little vitamin D.

Check that the one you take has 1,000 IU of vitamin D or take a separate supplement, especially if you don’t spend much time in the sun.

In the table below, we summarize data on vitamin D RDA, as recommended by the NIH.

Recommended Dietary Allowances for Vitamin D

Age	Male	Female	Pregnancy	Lactation
0–12 months*	400 IU (10 mcg)	400 IU (10 mcg)
1–13 years	600 IU (15 mcg)	600 IU (15 mcg)
14–18 years	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)
19–50 years	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)
51–70 years	600 IU (15 mcg)	600 IU (15 mcg)
>70 years	800 IU (20 mcg)	800 IU (20 mcg)
* Adequate Intake

Vitamin D Deficiency

Why Do So Many People Have Low Levels of Vitamin D?

The following factors interfere with vitamin D synthesis and put people at risk of vitamin D deficiency:

Limited vitamin D synthesis from the sun

People who live further away from the equator tend to experience lower synthesis rates because at these latitudes there is less exposure to solar radiation.

So, people living in northern USA and Canada, and northern Europe experience less UVB radiation and are at a greater risk of vitamin D deficiency.

Skin type

Black people have a higher risk of vitamin D deficiency as darker skin has a slower synthesis rate than lighter skin.

Sunscreen use

The use of sunscreens reduces the synthesis of vitamin D – if you apply it to your whole body, it completely blocks the vitamin D3 response to UVB.

Religion

Women who wear religious clothing outdoors, covering themselves up completely, have also been shown to suffer from vitamin D deficiency.

Weight

People who are overweight don’t make enough vitamin D from the sun.

Symptoms of vitamin D deficiency

Signs of vitamin D deficiency include often becoming sick or getting infections; feeling tired and fatigued; experiencing bone pain or lower back pain; feelings of depression; wounds that don’t heal easily; muscle pain and hair loss. But in many people, the symptoms are subtle and go unnoticed.

Deficiency effects on the body

A deficiency of vitamin D causes bones to soften and become weak. When this happens to an adult, it’s called osteomalacia, In children, it’s called rickets in children. Rickets and osteomalacia are extreme examples of the effects of vitamin D deficiency.

Low levels of vitamin D can lead to osteoporosis – insufficient vitamin D contributes to osteoporosis by reducing calcium absorption. Osteoporosis happens as a result of a long-term calcium and vitamin D insufficiency. With osteoporosis, bones become soft and can easily fracture or break.

Vitamin D may also play an important role in several medical conditions, including diabetes, high blood pressure, glucose intolerance, cancer and autoimmune conditions like multiple sclerosis. Research is ongoing to establish what this connection is.

Vitamin D deficiency in newborn babies

Do babies need vitamin D supplements? The American Academy of Pediatrics (AAP) recommends 400 IU per day for infants. While formula-fed infants receive Vitamin D supplementation from the formula, the AAP says that infants often don’t get enough of the vitamin in.

The AAP recommends that infants who are breastfed or consume less than 1 liter (just under 1 quart, or 33.8 ounces) of infant formula per day should receive an oral Vitamin D supplement.

Vitamin D and joint pain

The physical symptoms of a deficiency may include muscle pain in the joints like the knees, legs, and hips.

Some research links vitamin D deficiency to rheumatoid arthritis (RA), which is a chronic inflammatory condition that affects the joints.

A meta-analysis of 15 studies that included a total of 1,143 RA patients and 963 controls found that RA patients had notably less vitamin D in their blood than people without RA. They also found that people with RA were more likely to have a vitamin D deficiency.

Vitamin D deficiency and burning mouth

Burning mouth syndrome (BMS) is mouth pain that has no known cause. One study found that a deficiency of a number of vitamins and minerals, including vitamin D might be involved in the syndrome.

Vitamin D deficiency and cognitive dysfunction

Cognitive dysfunction means unusually poor mental function. Cognitive dysfunction manifests as confusion, memory loss and difficulty to concentrate and focus.

Many studies have linked poor vitamin D levels to poor mental function.

A 2017 systematic review and meta-analysis of 26 observational and 3 intervention studies found low levels of vitamin D was associated with cognitive decline and poorer cognitive performance among participants who did not have dementia.

The study involved more than 19,000 study participants. However, the scientists found that vitamin D supplementation didn’t benefit the patients.

A study published in 2017 found vitamin D deficiency was associated with a nearly 3-fold increased risk of developing Alzheimer’s disease (AD).

A systematic review and meta-analysis of Vitamin D, cognition, and dementia published in the journal Neurology included 37 studies.

The scientists concluded that lower vitamin D levels are associated with poorer cognitive function and a higher risk of AD.

Vitamin D deficiency and mental illness

Research around the globe has found a link between vitamin D deficiency and the development of schizophrenia. One meta-analysis reviewed 19 studies published between 1988 and 2013.

There were 2,804 participants in these studies. More than 65% of the participants with schizophrenia were vitamin D deficient.

Seasonal Affective Disorder (SAD) is a type of depression brought on by the change in seasons. People typically suffer from SAD during the long winter season in the northern hemisphere when there is little or no sun.

A team of researchers at the University of Georgia found a link between lack of sunshine and SAD. Their investigations led them to believe that vitamin D was likely to be a contributing factor in seasonal depression.

There are many studies that confirm a link between low vitamin D levels and mental illness.

Major and minor depression are also linked to low vitamin D levels.

An Iranian study found that school children who were vitamin D deficient were more likely to be anxious, worried, depressed and sad that children who were sufficient in vitamin D levels.

Vitamin D and diabetes

There seems to be a link between vitamin D and diabetes.

The vitamin is believed to help improve the body’s sensitivity to insulin. Insulin is the hormone responsible for regulating blood sugar levels. Through its role, vitamin D can reduce the risk of insulin resistance, which often leads to type 2 diabetes.

Some scientists also believe this vitamin may help regulate the production of insulin in the pancreas.

Vegan diet and vitamin D

Although fatty fish, cod liver oil and eggs are dietary sources of vitamin D, most people, including non-vegetarians, get their vitamin D from sunshine and fortified foods.

In the absence of food sources like fish and eggs in the vegan diet, it must be supplemented with fortified foods or supplements.

Does vitamin D deficiency cause fatigue?

Excessive fatigue and tiredness can have many causes. It can also be a sign of vitamin D deficiency.

On 2015 study found that a 61-year-old man who suffered from severe daytime fatigue had a very low vitamin D serum level. He received supplements and his symptoms disappeared.

In another case, a woman complained of chronic daytime fatigue, chronic lower back pain and pains in her thighs pain, as well as daily headaches.

She was found to have a very low vitamin D blood level. After receiving a vitamin D supplement, her vitamin levels improved and her symptoms disappeared.

Vitamin D as a Supplement

Does vitamin D supplementation improve bone mineral density?

Vitamin D supplements have long been prescribed to improve bone mineral density and prevent fractures or falls in adults. However, according to the latest research findings, over-the-counter supplements don’t contribute to bone health.

The research looked at data from 81 randomized controlled trials, involving more than 53,000 people. Most were women over the age of 65.

The scientists concluded that vitamin D supplementation doesn’t cause fewer fractures or falls and has no real effect on bone mineral density.

They went so far as to say: “There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health.”

Do tanning beds help with vitamin D levels?

Treatment of vitamin D deficiency with UV light has been studied with patients who were unable to absorb vitamin D from their diet.

The researchers concluded that a UV lamp that emits ultraviolet radiation similar to sunlight is an excellent alternative for cystic fibrosis and short bowel syndrome patients. These patients suffer from vitamin D deficiency due to fat malabsorption.

Does vitamin D supplementation help for lower back pain?

A systematic review and meta-analysis of 3,534 articles and 8 clinical trials have found that vitamin D is no more effective than a placebo, no intervention, or other conservative/pharmacological interventions. The writers of the review don’t recommend the prescription of vitamin D for lower back pain.

Symptoms of taking too many vitamin D supplements

If you take megadoses of vitamin D supplements, it can lead to vitamin D toxicity. It’s a rare but serious condition.

The main consequence of vitamin D toxicity is a buildup of calcium in the blood. Extremely large doses of vitamin D, on the order of 100,000 units per day, are required to cause hypercalcemia, so most people need not worry about getting an overdose.

There is increasing scientific evidence of the importance of vitamin D in our diets. Most people, although not vitamin D deficient, don’t get enough vitamin D.

Our best source of the vitamin is sunshine, but for various reasons, people don’t spend enough time in the sun to make enough vitamin D.

Boston University scientists in their 2013 overview, Sunlight and Vitamin D: A global perspective for health, suggested a three-pronged strategy of increasing food fortification programs with vitamin D, sensible sun exposure and encouraging ingestion of a vitamin D supplement when needed to prevent global vitamin D deficiency and its negative health consequences.

Omega 3 Supplements

People have talked about the importance of omega-3 essential fatty acids for decades and fish oil is one of the most popular supplements. But do you actually know what omega-3 does for your body and your brain?

What is omega-3?

Omega-3 essential fatty acids (EFAs) are healthy fats that form part of your cell membranes.

They also give you energy and play an important role in many of the main systems in your body, including your immune system, blood vessels, and lungs. They are crucial for the production of the hormones that control your moods and appetites.

According to a report published by the Harvard School of Public Health, omega-3 essential fatty acids are so important to your health, low levels could cause up to 96,000 deaths a year in the US.

Omega-3s are called essential fatty acids because your body can’t make them itself.

There are three main omega-3 essential fatty acids:

What is the omega-3:omega-6 ratio?

You might have heard about omega-6, another essential fatty acid that is generally talked about as being a bad fat. This is confusing since we are taught to believe essential fatty acids are overwhelmingly good for our health.

Omega-6 is also an essential nutrient. In modern diets, though, we tend to consume too much omega-6 as it is readily available in foods we eat – vegetable oil, meat, poultry, and eggs.

While some scientists suggest that it's important to balance the ratio between omega-6s and omega-3s, however, the optimal range has not been established yet. Most researchers agree that raising EPA and DHA blood levels is far more important than lowering omega-6s.

What is the recommended dosage for omega-3?

The NIH recommends an omega-3 daily intake for adults of 1.6 g (men) and 1.1 g (women).

There's evidence that links higher intakes of fish and other seafood with improved health outcomes. It's difficult however to ascertain if the benefits are caused by the omega-3 content of seafood, other components, or other healthy behaviors connected to eating seafood.

More research, and specifically more randomized clinical trials are needed to answer these questions.

Below is the updated recommended intake of ALA for adults, children, and pregnant or lactating women.

Adequate Intakes (AIs) for Omega-3s

Age	Male	Female	Pregnancy	Lactation
Birth to 6 months*	0.5 g	0.5 g
7–12 months*	0.5 g	0.5 g
1–3 years**	0.7 g	0.7 g
4–8 years**	0.9 g	0.9 g
14–18 years**	1.6 g	1.1 g	1.4 g	1.3 g
19-50 years**	1.6 g	1.1 g	1.4 g	1.3 g
51+ years**	1.6 g	1.1 g
*As total omega-3s **As ALA

Recommended doses of EPA and DHA have not been established. However, dietary recommendations for EPA and DHA based on cardiovascular risk considerations for European adults are between 250 and 500 mg/day.

So, here is the key takeaway: the confusion around supplementing your diet with omega-3 fish oils stems from the fact that there's not a widespread consensus among scientists around if and what amount of EPA/DHA intake should be taken daily.

The recommended dose refers to ALA, the type of omega-3 you can get from a lot of plant-based nutrients.

Which foods are high in Omega 3?

These are the best food sources of omega-3, according to the NIH:

Selected Food Sources of ALA, EPA, and DHA

Food	ALA	DHA	EPA
Flaxseed oil, 1 tbsp	7.26
Chia seeds, 1 ounce	5.06
English walnuts, 1 ounce	2.57
Flaxseed, whole, 1 tbsp	2.35
Salmon, Atlantic, farmed cooked, 3 ounces		1.24	0.59
Salmon, Atlantic, wild, cooked, 3 ounces		1.22	0.35
Herring, Atlantic, cooked, 3 ounces*		0.94	0.77
Canola oil, 1 tbsp	1.28
Sardines, canned in tomato sauce, drained, 3 ounces*		0.74	0.45
Mackerel, Atlantic, cooked, 3 ounces*		0.59	0.43
Salmon, pink, canned, drained, 3 ounces*	0.04	0.63	0.28
Soybean oil, 1 tbsp	0.92
Trout, rainbow, wild, cooked, 3 ounces		0.44	0.40
Black walnuts, 1 ounce	0.76
Mayonnaise, 1 tbsp	0.74
Oysters, eastern, wild, cooked, 3 ounces	0.14	0.23	0.30
Sea bass, cooked, 3 ounces*		0.47	0.18
Edamame, frozen, prepared, ½ cup	0.28
Shrimp, cooked, 3 ounces*		0.12	0.12
Refried beans, canned, vegetarian, ½ cup	0.21
Lobster, cooked, 3 ounces*	0.04	0.07	0.10
Tuna, light, canned in water, drained, 3 ounces*		0.17	0.02
Tilapia, cooked, 3 ounces*	0.04	0.11
Scallops, cooked, 3 ounces*		0.09	0.06
Cod, Pacific, cooked, 3 ounces*		0.10	0.04
Tuna, yellowfin, cooked 3 ounces*		0.09	0.01
Kidney beans, canned ½ cup	0.10
Baked beans, canned, vegetarian, ½ cup	0.07
Ground beef, 85% lean, cooked, 3 ounces**	0.04
Bread, whole wheat, 1 slice	0.04
Egg, cooked, 1 egg		0.03
Chicken, breast, roasted, 3 ounces		0.02	0.01
Milk, low-fat (1%), 1 cup	0.01
*Except as noted, the USDA database does not specify whether fish are farmed or wild caught. **The USDA database does not specify whether beef is grass fed or grain fed.

What are the health benefits of omega-3?

Omega-3 and child development

Science suggests that omega-3 is vital for unborn babies, infants, and children as it is so important for brain and eye development. Consumption of at least 8 ounces per week of seafood that contains DHA is associated with better infant health outcomes.

Both the Dietary Guidelines for Americans and the American Academy of Pediatrics recommend consumption of seafood to provide pregnant and lactating women with EPA/DHA.

The Dietary Guidelines for Americans recommend 8–12 ounces of seafood per week preferring salmon, herring, sardines, and trout. Fish high in mercury like king mackerel, shark, swordfish, and tilefish should be avoided and tuna should be consumed with caution.

The American Academy of Pediatrics says intakes of 200–300 mg DHA per day guarantee a sufficient amount of DHA in breast milk. This can be achieved by consuming one to two servings of fish per week, choosing among the kinds low in mercury.

Concerns regarding methyl mercury contained in seafood should be taken into account, however many studies, including a systematic review of the literature on maternal fish intake and subsequent neurodevelopmental outcomes, show that the benefits outweigh the risks.

Many randomized controlled trials have examined whether supplementation with fish oil, EPA, and/or DHA during pregnancy and early infancy is beneficial for infant health and neurodevelopment.

A comprehensive 2016 AHRQ Publication on this topic examined results from 95 randomized controlled trials and 48 prospective longitudinal studies.

Except for small beneficial effects on infant birth weight and length of gestation, omega-3 supplementation or fortification appears to show no consistent effects on infant health outcomes.

Omega-3 for a healthy heart

People who live in communities that eat a lot of fish are less likely to suffer from heart disease and stroke. Fish oil may help to lower blood pressure and regulate cholesterol levels. It may also prevent blood clots by preventing platelets clumping together.

Omega-3 fats are also known to lower triglycerides which are a major risk factor for heart disease. For this reason, the American Heart Association recommends eating fish twice a week for a healthy heart.

Omega-3 to reduce inflammation

Scientists often talk about inflammation as the root cause of many health problems. The anti-inflammatory properties of omega-3 may help prevent disorders caused by inflammation and reduce their symptoms.

People suffering from arthritis often find omega-3s help reduce joint stiffness and pain.

The results of an animal study suggested omega-3 might be as effective as traditional medications in reducing inflammation with the added benefit of fewer side-effects, particularly for people with sensitive stomachs.

Omega-3 as a brain-food

Omega-3 is often talked about as a great brain food because it is thought to be an effective anti-inflammatory and useful in regulating hormones.

As well as helping to keep your brain young and well-nourished, omega-3 may help prevent diseases related to the brain including:

• Alzheimer’s and dementia – particularly memory loss
• Depression – omega-3s may also help antidepressants work more effectively
• ADHD – particularly by improving thinking, learning and memory processes

Omega-3s and autoimmune diseases

Autoimmune diseases including type-1 diabetes, rheumatoid arthritis, and multiple sclerosis can be very difficult to diagnose due to the range of symptoms. People who consume a high level of omega-3 are less likely to suffer from autoimmune diseases, and it might also improve symptoms.

Omega-3 and cancer

More research is needed, but scientists think that higher levels of omega-3 essential fatty acids can reduce your risk of getting some cancers, including colorectal cancer and hormonal cancers such as breast and prostate cancers.

Omega-3 and bones and joints

As well as lubricating bones and joints and reducing stiffness, omega-3 fats help your body absorb calcium and is good for bone collagen which could help make your bones stronger.

Omega-3 and sleep

Adults and children may have trouble sleeping if they don’t consume enough omega-3. This may be because low levels of omega-3 often lead to low levels of melatonin, the hormone that signals to your body it’s time to go to sleep.

Omega-3 and menstrual pain

Some women have reported that supplementing with omega-3 has lead to reduced menstrual pain.

Omega-3 and skin

Omega-3 essential fatty acids are thought to be good for your skin because they are reported to slow the aging process and manage inflammation that can cause acne and other skin disorders.

Are there any side effects from omega-3?

There are few side effects from eating foods that contain omega-3, but if you have a health condition and choose to take a supplement you should always check with your doctor first.

There is some evidence that omega-3 supplements can affect people who have bleeding conditions and may interfere with medications that are prone to increasing bleeding including warfarin and some NSAIDs. If you take medications, check with your doctor before starting a supplement.

Sometimes omega-3 supplements can cause indigestion and gas. If this is the case for you, try a supplement with a coating.

Are Probiotics Good for Your Health?

In 2017 the global market for probiotics was estimated to be around $45.64 billion and this figure rises every day.

You might have read about the health benefits of probiotics and wondered if they really can aid digestion, help fight infection, and boost the health of your brain.

They are even considered by some to be an effective treatment for autism, acne, and help prevent allergies.

Are probiotics another wonder-nutrient or do they only actually benefit the food industry?

What are Probiotics?

Germs get a bad press because we often think they cause infection. But some bacteria are good for your health.

Probiotics line the wall of your digestive system. They help to absorb nutrients efficiently from the food you eat and they may even help fight infection.

Doctors often prescribe probiotics to help with gut problems and to replace the good bacteria lost while taking antibiotics. Probiotics also provide a balance between good and harmful bacteria to help your body work efficiently.

Health Benefits of Probiotics

A healthy gut isn’t only important for good digestion, it also plays a crucial role in your immune and neurological systems.

Probiotics and digestion

Probiotics are most often used to help with digestion and help treat disorders of the gut. This is good news if you’re one of the 60-70 million Americans suffer from digestive disorders, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

There is evidence that probiotics are particularly useful in treating Irritable Bowel Syndrome (IBS) and inflammatory bowel diseases such as ulcerative colitis. They have shown to be effective in relieving the symptoms of diarrhea, including diarrhea caused by antibiotic treatment.

Probiotics for brain health

The gut is often called the second brain as there are so many links between these two vital organs.

Serotonin, a hormone that boosts your mood and helps your brain work effectively, is mostly made in the gut. The results of animal studies have suggested that probiotics can help relieve the symptoms of anxiety, probably by reducing inflammation, and depression.

More research is needed, but early studies seem to suggest that probiotics could play a role in the treatment of autism.

Probiotics and the immune system

80% of the immune system is in the gut, so by using probiotics to balance the good and bad bacteria in your digestive system, you may be able to help your body fight back against infection.

It is thought that the anti-inflammatory effects of probiotics might be the reason they are so good for your immune system.

Probiotics and antibiotics

Probiotics are often used to counterbalance the side-effects of antibiotic treatment. While fighting infection, antibiotics tend to kill off good as well as bad bacteria.

So, increasing your probiotic intake during antibiotic therapy might help redress the balance and reintroduce good bacteria to your system.

Probiotics for babies

Studies have shown that when women take a multi-strain probiotic during pregnancy and continue while breastfeeding or give their babies probiotic-fortified formula, the infants are less likely to suffer from serious diseases such as necrotizing enterocolitis and neonatal sepsis.

Probiotics for healthy skin

The inflammation-busting properties of probiotics may also be the reason it’s so good for your skin.

Probiotics have been shown to reduce symptoms of atopic dermatitis in children and eczema in babies. It may also help relieve the symptoms of acne.

How do We Include Probiotics in Our Diet?

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In the past, we consumed all the probiotics we needed just by eating food produced free from modern farming and manufacturing methods. Our ancestors also ate a lot of fermented food as it was a key method of preventing it from going bad.

The foods you eat today, unfortunately, contain fewer probiotics naturally. We also lose good bacteria as they are affected by antibiotics and other medications; too much sugar, processed foods, and alcohol; lifestyle issues such as stress, smoking, poor sleep and lack of exercise; and too many harsh chemicals in cleaning products.

But we can make an effort to include foods naturally rich in probiotics in our daily diet.

Probiotic foods

Yogurt

Yogurt is one of the most accessible forms of probiotic but you must be careful to choose live yogurt or greek yogurt. The quality of yogurt varies considerably. To get the best health benefits, look for yogurt made from the organic milk of grass-fed cows, sheep, and goats.

Yakult

Yakult is a convenient way of consuming probiotics as a single serving comes in a little bottle that can easily be purchased at the grocery store. Be careful, though. Yakult and other commercially available probiotic drinks often contain ingredients to be wary of such as sugar or sweeteners.

Kefir

Kefir is one of the oldest fermented foods as it has been consumed for over 3000 years. It’s a fermented dairy product, similar to yogurt, that is made from of a combination of milk and kefir seeds. As the lactose in the milk is broken down by the yeasts in the kefir seeds, it may even be used by people with lactose intolerance without side-effects.

Kombucha

Kombucha is a black tea fermentation that is made using a SCOBY (symbiotic colony of bacteria and yeast).

Sauerkraut and kimchi

Sauerkraut and kimchi are fermented vegetables that support the growth of good bacteria in your gut.

Miso

Miso is a key ingredient in Japanese medicine. A bowl of miso soup is a common way to start the day in Japan.

Probiotic supplements

Supplements are an alternative to probiotic-rich foods but there are a few things to bear in mind.

When choosing supplements it’s always important to go for the best quality options. The FDA categorizes probiotics as a food rather than a medication, so be aware that they don’t go through the same checks for safety and efficacy that drugs go through.

When choosing a probiotic supplement, make sure it is from a reputable brand and has a CFU (colony forming unit) count of 15-100 billion. It should not contain sugar but may have other ingredients that boost digestion such as turmeric, ginger, chia seeds, and flax seeds.

Look for supplements that contain live and active cultures as these are less likely to have gone through a manufacturing process that includes high temperatures that can kill off the good bacteria.

Are There Any Side Effects from Taking Probiotics?

Two recently published studies cast some doubts on the widespread, untargeted use of probiotics.

In one of the studies, some of the people who participated showed resistance to any effect from probiotics: their gut microbiome did not change after taking them.

The natural microbiome composition and the immune system seemed the determining factors to decide whether a person would be resistant to colonization by probiotics.

In the other study, scientist investigated whether patients should take probiotics after treatment with antibiotics to help the recovery of the natural gut bacteria.

While probiotics colonized the gut of people who took them after antibiotics treatment, they seemed to delay the return of the normal gut microbiome compared people who had no intervention and the people who received a transplant of their own gut bacteria.

Conclusions

Here's the key takeaway.

We need to progress from one-size-fits-all, universal company-made vitamins and supplements to personalized supplements based on individual needs and micronutrients testing. Always consult your physician before taking any medications or supplements.

And when you do buy them, make sure you check the quality of the supplements you are taking: their purity, safety, testing methods.

Carefully check the list of ingredients and avoid supplements that use synthetic fillers or artificial food colorings (Blue No. 1, 2, or 3, Red No. 3 or 40, or Yellow No 5 or 6) to make them look more appealing, as well as partially hydrogenated soybean oil.