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  • Submitted: Jun 21 2017 11:57 AM
  • Date Updated: Jul 04 2017 10:12 AM
  • Views: 964

Multi- Vitamin and Mineral stack

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magnesium vitamin d3 vitamin k1 + k2 (mk4 + mk7) omega 3 fish oil vitamin c vitamin b complex multi vitamin/mineral vitamin a alpha + gamma tocopherols mixed tocotrienols or coq10

Description

Hello everyone,

one common question on the forums is for the perfect Multivitamin and mineral. In my experience most likely there never will be one. We all are just too different in our individual nutritional needs.

How Much is Too Much? : Appendix B: Vitamin and Mineral Deficiencies in the U.S.

Nutrient from food alone, ranked by the occurrence of dietary inadequacy among adults | Percentage of dietary intakes below the estimated average requirement for a specific population* | Naturally occurring sources of nutrient**

2-to-8-year-old children | 14-to-18-year-old girls | Adults 19 and older

Vitamin D | 81% | 98% | 95% | Fatty fish, mushrooms [vitamin D is naturally formed in the body when skin is exposed to sunlight; vitamin D is added to fortified milk]

Vitamin E | 65% | 99% | 94% | Nuts, seeds, vegetable oils, green leafy vegetables

Magnesium | 2% | 90% | 61% | Whole grains, wheat bran and wheat germ, green leafy vegetables, legumes, nuts, seeds

Vitamin A | 6% | 57% | 51% | Preformed vitamin A: liver, fatty fish, milk, eggs; provitamin A carotenoids: carrots, pumpkins, tomatoes, leafy green vegetables

Calcium | 23% | 81% | 49% | Milk, yogurt, cheese, kale, broccoli

Vitamin C | 2% | 45% | 43% | All fruits and vegetables, particularly citrus fruits and tomatoes

Vitamin B6 | 0.1% | 18% | 15% | Many foods; highest levels in fish, beef, poultry, potatoes and other starchy vegetables, and fruit other than citrus

Folate | 0.2% | 19% | 13% | Many foods; highest levels in spinach, liver, asparagus, Brussels sprouts [mandatory, standardized addition to enriched flour and flour products]

Zinc | 0.2% | 24% | 12% | Red meat, poultry, beans, nuts, some seafood, whole grains

Iron | 0.7% | 12% | 8% | Highest amounts in meat and seafood; lower levels in nuts and beans [mandatory, standardized addition to enriched flour and flour products]

Thiamin | 0.1% | 10% | 7% | Whole grain products [mandatory, standardized addition to enriched flour and flour products]

Copper | 0% | 16% | 5% | Shellfish, whole grains, beans, nuts, potatoes, organ meats (kidneys, liver)

Vitamin B12 | 0% | 7% | 4% | Animal products: fish, meat, poultry, eggs, milk

Riboflavin | 0% | 5% | 2% | Milk and dairy products, eggs, meat, green leafy vegetables, legumes [mandatory, standardized addition to enriched flour and flour products]

Niacin | 0.1% | 4% | 2% | Meat, fish, seeds and nuts, whole grains [mandatory, standardized addition to enriched flour and flour products]

Selenium | 0% | 2% | 1% | Found in different plant and animal foods; highest levels in seafood and organ meats (kidneys, liver)


These are just 'calculated' from nutrient-intake questionnaires. Calculations with a nutrient-software like cron-o-meter aren't much more dependable, since it again doesn't actually measure individual deficiencies in body stores. Additionally the definition of nutritional deficiency is based on a RDA for the prevention of the worse kind of deficiencies, but aren't representing intake levels for optimal physiological functioning. Which again, can be highly individual. Only a combination of lab-testing could access it somewhat accurately.

Then there are a couple of nutrients to really be aware of and possibly avoided. One always has to check for in the ingredients-list of any combination product:

Iron, Copper and Manganese: are probably fine less than 2 mgs per day - we already get multiples of that from diet. However - even with a multi without these - it's always advisable to get serum ferritin and copper tested (for example 2 mgs of additional copper gave me personally too high values, with 1 mg I'm fine). For about 5% of the population with probable Iron-overload the Iron from food is already too much to handle. Men and post-menopausal females are at higher risk too (while for me as vegetarian only betain-hcl brought iron stores up). Zinc and Copper have to be balanced (I seem to do best with a 10:1 ratio from diet and supplements combined).

Vitamin E: avoid synthetic dl-alpha tocopherol instead of natural l-alpha tocopherol. Which if taken alone would replace all other natural isomers of Vitamin E (β-, γ-, and δ-tocopherol). Therefore always good to supplement with the other tocopherols too by alternating their intake (ie. at alternating days; my diet alone gives me a 4:3 ratio between αlpha and other tocopherols). As well as the beneficial tocotrienols difficult to get from diet.

Vitamin B9: Folic acid is a synthetic form of Vitamin B9 which needs a number of internal reactions to be converted to its active form in the body, where up to 50% of the population have genetic variants which makes that more difficult to accomplish. Additionally with to high an intake (think about hidden in fortified food) folic acid blocks receptors for biological active Vitamin B9, read at about 1 mg per day. Which would make one deficient despite supplementing the right form. So really no good reason not to supplement with the better forms of folates, like l-methylfolate or folinic acid, and avoid folic acid as much as possible

Syntetic B Vitamins: though not that important as with folate, it's always better to get more bioavailable forms of the other B-Vitamins. Especially since they are available reasonable priced too. Benfotiamine or Sulbutiamine instead of Thiamine. Riboflavin-5-phosphate for B2. PPC, Citicoline or Alpha-GPC for Choline. Pyridoxal or Pyridoxamine instead of Pyridoxine (which needs much higher doses for same effects). Methylcobalamin, Adenosylcobalamin or Hydroxylcobalamin instead of the usual Cyanocobalamin.

Beta-Carotene: Again, in up to 50% of the population doesn't get's converted in the body into active Vitamin A. Additionally there are some infamous studies which showed an slight increase of lung cancer in former smokers with high dose Beta-Carotene. But due to a overestimated toxicity of preformed Retinol, most supplement producers now decreased it (like to 10% in LEFs two-per-day multi). Therefore check there isn't too much Beta-Carotene in yours, and if necessary get additional preformed Vitamin A (let serum tests guide you. Preformed Vitamin A is needed to be balanced with high Vitamin D)

Calcium: consider the often heard optimal ratio between Calcium and Magnesium of 2:1 dangerously high, unless otherwise indicated. Conversely, to supplement in a 1:2 ratio seems to be more appropriate.

Proprietary Blends: allegedly created to protect an innovative blend of synergistic nutrients from being imitated by the competition. In actuality they most often hide that expensive ingredients are in minute amounts, and inexpensive make the bulk. You ideally would want to know how much of each ingredient you're ingesting, and the different effects from varying doses.


Therefore, especially with already some health difficulties showing up, the first I would recommend would be to get rid of always possible unnecessary nutrient deficiencies first:

1) Magnesium
2) Vitamin D3
3) Vitamin K-Complex
4) Omega-3 Fish oil
5) Vitamin C
6) Vitamin B-Complex
7) Multivitamin/mineral
8) Vitamin A (linked to affordable products available in the EU, since in the US most is reasonable available anyway. The following aren't:
9) Tocopherols
10) Tocotrienols

And after having covered the bases this way, go from there. Always start with lowest possible doses and gradually increase. Found in my case only a fraction of the Multi is best to avoid particular nutrients at too high a dose for me, and other nutrients needed at higher doses again added individually.

There you have it, the not so perfect multi, due to having to take at least 10 individual supplements.



Obligatory disclaimer for Orwellian times: “These statements have not been evaluated by the Food and Drug Administration. They are not intended to diagnose, treat, cure, mitigate or prevent any disease.”

Ingredient Dosage Frequency Administration
Magnesium 500 mg Daily adjust dose according to RBC level, spread out, with or without food
Vitamin D3 2.000 IU Daily adjust dose according to serum level, with fatty meals
Vitamin K1 + K2 (mk4 + mk7) 1.700 µg Daily adjust dose according to risk factors, with fatty meals
Omega 3 fish oil 4 gram Daily adjust dose according to risk factors, with fatty meals
Vitamin C 4 gram Daily adjust dose according to risk factors, 20 minutes before meals
Vitamin B complex 1-2 pill(s) Daily with or without meals
Multi Vitamin/Mineral 1-2 pill(s) Daily with meals
Vitamin A 1-2 pill(s) Daily adjust dose according to serum level, with fatty meals
Alpha + Gamma Tocopherols 1 pill(s) 3x weekly with meals
Mixed Tocotrienols or CoQ10 1 pill(s) 3x weekly with meals


A note of caution on preformed vitamin A. You're right that the acute toxicity of very high levels of retinol has possibly been overestimated, but there is significant evidence that high intake of preformed vitamin A increases fracture risk. The studies aren't totally consistent; notably, studies based on serum levels are far less likely to find an association, but that may be because serum retinyl esters poorly track high dietary intake. Even so, a meta-analysis of prospective studies concluded that both high dietary and high blood retinol are associated with elevated fracture risk.

high intake of preformed vitamin A increases fracture risk.

Ref: Excess Vitamin A Can Thwart Vitamin D

Osteoporosis is caused by a mismatch between vitamin A, D, and K2.  The ideal A/D ratio wt/wt is about 5 to 1 which corresponds to an iu/iu ratio of 1 to 2.4 since 1 mg of vitamin A is 3,333 iu and 1 mg of  vitamin D3 is 40,000 iu  so  5 g to 1 g  = (5)(3,333 iu)/40,000 iu =  1 to 2.4  iu/iu

 

Example:  vitamin A retinol at 1,000 iu per day needs 2,400 iu per day of D3.

 

The "more is better" supplements are ridiculous--a quick look a Amazon show "vitamin A" in 5,000 to 25,000 iu capsules (likely mostly beta-carotene).  A 25,000 iu dose of retinol would need to be balanced with 2.4 x 25,000 = 60,000 iu of D3.  Perhaps you could take one 25,000 iu vitamin A (as retinol) per month and balance it with 2,000 iu of vitamin D3 daily.

Thanks for both comments, only saw them now.

 

I'm thinking more in line with Chris Masterjohn. And got his ideas confirmed through vitamin A and D serum testing, while aiming at the middle of normal ranges. In that I actually need at least a A to D IU ratio of 2 to 1 (the opposite RWhigham suggests). With the higher intake of preformed vitamin A, always slowly titrating and measuring, also infrequent psoriasis outbreaks have ceased (above 24.000 IU/d). But everyone is different, where only individual testing counts.

 

The problem I have with all the references you both provide, is that they look completely unrealistically at one vitamin - A or D in isolation only. That's how I never would even think of them, or further excluding vitamin K2 in all their synergistic effects.

In principle, I'd agree that we'd want to be able to evaluate the whole system working together — but I don't know of any proper data on the subject, even in animals. The studies cited in the posts that you and RWhigham link cite are biochemistry, acute toxicity, and rather speculative inductions (eg, that the reason why trials conducted in the 1930s showed that cod liver oil reduced incidence of common colds and respiratory infections but that a 2004 trial yielded mixed results is that the cod liver oils differed in A and D content, and should have had higher D and lower A than the 2004 trial — or that the reason for low 25(OH)D3 in LEF members is excessive vitamin A supplementation from non-LEF multivitamins, even though the article itself says that "Most Foundation members take the Two-Per-Day or Life Extension Mix multi-nutrient formulas," which by their notions of a correct vitamin A dose do not suffer this problem).

 

Are either of you aware of any long-term studies in otherwise-normal, aging mammals testing the effects of different ratios of vitamins A, D3, and K2 against hard health outcomes?

I'm still searching, but I doubt there is any research of A, D3 and K2 in combination with hard health outcomes yet. Only have my own anecdotal case of being plagued with a number of devastating chronic diseases, and without much to loose, therefore was more than willing to experiment while monitoring. I didn't regret.

 

However, you might be absolutely right in that the A:D ratio which worked for me, might turn out completely off in a healthy person. Therefore always worthwhile testing serum retinol and retinol binding protein for confirmation. As an example of a very healthy person, what kind of serum levels you get with A and D?