Vitamin and mineral supplements

{{bronze}}[[Image:VitaminAdd.jpg|thumb|upright|165px|A supplement advertisement that offers to [[Panacea|Help with Everything that Ails]].]]
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{{hatnote|Note: This information applies to adults.  Children should not be given any medications or supplements not recommended by their doctor and should take all medications recommended by their doctor. The main purpose of the article is to separate vitamin myth from fact, not to give medical advice.}}

{{cquote|And remember - no matter what a supplement maker claims, dietary supplements are not intended to treat, diagnose, cure, or relieve the effects of diseases.|||American Cancer Society<ref>[https://www.cancer.org/cancer/managing-cancer/treatment-types/complementary-and-integrative-medicine/dietary-supplements/safety.html Are Dietary Supplements Safe?]. cancer.org.</ref>}}

'''Vitamin supplements''' are [[vitamin]]s sold with specific health claims beyond their usual physiologic function. Vitamins are micronutrients which are required in very small amounts for specific physiologic processes.  Since their discovery, there has been great interest in using vitamins not just to treat deficiency diseases but also for medicinal purposes. Like everything else in [[Naturopathy|natural]]/[[holistic health]], the claims run the gamut of factual, [[science|scientific]] efficacy. A few claims are backed by scientific study, though most are simple salesmanship and a few have even been irresponsibly, dangerously extravagant.

Vitamin and mineral supplements have often been the subject of [[Fad diet|faddism]].<ref name=apple>''Vitamania: Vitamins in American Culture'' by Rima D. Apple (1996) Rutgers University Press. ISBN 0813522781.</ref>{{rp|149}} Supplements have often been promoted via [[advertising]] using a variety of [[logical fallacies]] based on [[Fear, uncertainty, and doubt|fear]],<ref name=apple/>{{rp|19-22}} such as "[[think of the children]]", including implicitly with "scientific motherhood".<ref name=apple/>{{rp|19-24}} Such fears eventually coalesced into a [[health freedom]] [[moral panic]], resulting in a deluge of angry consumer letters to the [[Food and Drug Administration]] demanding access to dietary supplements, starting in 1973.<ref name=apple/>{{rp|142-157}}

Despite often being [[Appeal to nature|touted as "natural"]], supplemental vitamins are actually often synthetic: vitamin pills are not often found growing from wild plants, and it might be shocking to know that prehistoric humans did not forage for bottled hyper-saturated nutrients in the bushes. This is because "our bodies appear to absorb synthetic forms as well as they do natural forms" (assuming both forms are chemically identical, no shit, Sherlock) and because vitamin manufacturers want to add the most stable form of vitamins, and these forms are not always natural.<ref>[https://www.scientificamerican.com/article/do-vitamins-in-pills-diff/ Do vitamins in pills differ from those in food?] by Christine Rosenbloom & Luke Bucci (2003) ''Scientific American''.</ref> Of course, this doesn't actually have anything to do with them being good or bad; we're just noting the faulty logic of many people who espouse taking supplemental vitamins but attack things like [[vaccine]]s for being "unnatural."

The consensus from medical authorities and nutrition experts is that most vitamin and mineral supplements are not needed if one eats a well-balanced diet, with the exception of folate for people able to bear children and vitamin B<sub>12</sub> in some populations. Scientific studies have shown a [[Correlation does not imply causation|correlation]] between regular use of some vitamin supplements and an increased risk of cancer and heart disease.<ref>[https://www.theatlantic.com/health/archive/2013/07/the-vitamin-myth-why-we-think-we-need-supplements/277947/ The Vitamin Myth: Why We Think We Need Supplements]</ref><ref>[https://www.theguardian.com/society/2015/apr/21/vitamin-supplements-increase-risk-cancer-heart-disease-research Vitamin supplements can increase risk of cancer and heart disease]. theguardian.com.</ref><ref>Hamishehkar H, Ranjdoost F, Asgharian P, Mahmoodpoor A, Sanaie S. (2016). [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241405/ Vitamins, Are They Safe?]. Adv Pharm Bull 6(4): 467-477.</ref><ref>[https://www.sciencedirect.com/science/article/pii/S0735109718345601 Supplemental Vitamins and Minerals for CVD Prevention and Treatment]. sciencedirect.com.</ref>  There is no reliable evidence that dietary supplements can cure or control the growth of cancer.<ref>[https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative-therapies/individual-therapies/vitamins-diet-supplements Vitamins, diet supplements and cancer]. cancerresearchuk.org.</ref><ref>[https://www.wcrf.org/diet-activity-and-cancer/cancer-prevention-recommendations/do-not-use-supplements-for-cancer-prevention/ Do not use supplements for cancer prevention]. wcrf.org.</ref><ref name="Australia">[https://www.cancercouncil.com.au/cancer-prevention/diet-exercise/nutrition-and-diet/vitamin-supplements-and-cancer/ Vitamin supplements and cancer risk]. cancercouncil.com.au.</ref>

==Vitamin overview==
Vitamins are chemicals that are necessary for life and must be ingested, as the body is unable to produce them. In the industrialized world, vitamin-deficiency diseases are not very common, and usually related to dysfunctional diets, often associated with psychological disorders, or genetic and/or physiological disorders. You only need a certain amount of each vitamin (eating carrots will only improve your eyesight if you have a Vitamin A deficiency), and too much of some vitamins (called {{wpl|hypervitaminosis}}) can be toxic and even lethal.<ref group=note>The reasoning goes something like: "Vitamin C is essential for health, so lots of vitamin C should be even better!" The fallaciousness of this can be demonstrated with the statement: "Vitamin A is essential for health, so lots of vitamin A is even better!" (Vitamin A [http://www.spectrumchemical.com/MSDS/r0037.pdf causes liver damage] in high doses.) Or, to frame it in terms of something commonly known by CAM believers, "Sodium is essential for health, so lots of sodium is even better!"</ref> Despite this, an enormous number of Americans take [[vitamin supplement]]s daily, fuelling a [[Big Placebo|multi-million dollar industry]]. The term vitamin was coined in 1911 by Casimir Funk.<ref>https://web.archive.org/web/20190209180047/https://www.nobelprize.org/prizes/themes/the-nobel-prize-and-the-discovery-of-vitamins-2/</ref>

{|class="wikitable"
!Vitamin name!!Chemical Name
|-
|{{wpl|Vitamin A}}||Retinoids (retinol, retinoid) and carotenoids
|-
|{{wpl|Vitamin B1|Vitamin B<sub>1</sub>}}||Thiamine
|-
|{{wpl|Vitamin B2|Vitamin B<sub>2</sub>}}||Riboflavin
|-
|{{wpl|Vitamin B3|Vitamin B<sub>3</sub>}}||Niacin
|-
|{{wpl|Vitamin B5|Vitamin B<sub>5</sub>}}||Pantothenic acid
|-
|{{wpl|Vitamin B6|Vitamin B<sub>6</sub>}}||Pyridoxine
|-
|{{wpl|Vitamin B7|Vitamin B<sub>7</sub>}}||Biotin
|-
|{{wpl|Vitamin B9|Vitamin B<sub>9</sub>}}||Folic acid
|-
|{{wpl|Vitamin B12|Vitamin B<sub>12</sub>}}||Cobalamin
|-
|{{wpr|Vitamin C}}||Ascorbic acid
|-
|{{wpr|Vitamin D}}||Ergocalciferol and Cholecalciferol 	
|-
|{{wpl|Vitamin E}}||Tocopherol and Tocotrienol 	
|-
|{{wpl|Vitamin K}}||Naphthoquinone			
|}

This is a relatively short list, and most of these items can be found in a normal diet without much effort, the most notable exceptions being for [[vegetarian]]s and [[vegan]]s, as vitamin D and vitamin B<sub>12</sub> occur primarily in animal products (which doesn't mean either type of diet is necessarily unhealthy, just that they require more care to get everything one needs).

Clearly, there are situations when vitamin supplements can be useful, and there is a thriving industry supplying such pills. However, many companies want to go further in marketing supplements, and argue that there are other chemicals that are "vitamin-like" or desirable for health.  See [[pseudovitamin]] for some examples. In 1998, choline was found to be necessary for human nutrition and probably to meet the definition of a vitamin, making it the only true recent addition to the vitamin category; its actual status is still unsettled.

Other substances besides vitamins are also necessary for human nutrition.  Essential chemical elements are classified as minerals, not as vitamins. [[Water]], fats (and essential fatty acids), and [[protein]]s are also necessary, but are not vitamins because they are needed in large amounts.  In general, a vitamin is an organic compound (not a single element) that is needed by the human body in small amounts, is not always synthesized by the body in sufficient amounts, and must be obtained through the diet.  Vitamins D and K, although synthesized in the body, remain classified as vitamins because outside sources of these are sometimes needed.

==Vitamin industry==
[[Image:VitAd2.jpg|200px|thumb|left|Extravagant claims, and a free gift!]]
The [[Dietary supplements|dietary supplement]] industry is quite large, and the biggest part of the industry is [[vitamin]] sales.  Numbers are difficult to come by, as they are compiled and sold by [[marketing]] firms, but an estimate for 2012 was $32 billion dollars annually.<ref>[https://www.forbes.com/sites/davidlariviere/2013/04/18/nutritional-supplements-flexing-their-muscles-as-growth-industry/#4e240ccb8845 Nutritional Supplements Flexing Muscles As Growth Industry] by David Lariviere (Apr 18, 2013 @ 07:09 PM) ''Forbes''.</ref> There is much misinformation about the benefits of vitamins. This article will strive to help people make better decisions about vitamin supplementation, and help to sort out [[Extraordinary claims require extraordinary evidence|extravagant claims]] made by producers and marketers of vitamins.

Because of the great interest in vitamins as medications, a great deal of research has gone into investigating their safety and efficacy. However, in the [[US]], vitamins are regulated as dietary supplements, not medications, and there is no requirement for manufacturers to prove efficacy. By definition, vitamins are needed for health. In most cases, a basic, inexpensive, "general multivitamin supplement" is sufficient for adults to remain healthy. However, there is a growing body of evidence that multivitamins are unnecessary for those without vitamin deficiencies and could even cause harm in some isolated cases.<ref>[http://www.sciencebasedmedicine.org/more-evidence-that-routine-multivitamin-use-should-be-avoided/ More evidence that routine multivitamin use should be avoided] by Scott Gavura (December 19, 2013) ''Science-Based Medicine''.</ref><ref>[http://www.npr.org/blogs/health/2013/12/17/251955878/the-case-against-multivitamins-grows-stronger The Case Against Multivitamins Grows Stronger] by Nancy Shute (
December 17, 201312:37 PM ET) ''NPR''.</ref> Additionally, they are often marketed for uses far beyond their basic function and in much higher doses than typically needed.

The health claims used on the bottles are intentionally vague and non-specific (phrases such as "helps support", "promotes", or "bolsters"). With further protection from the [[Quack Miranda Warning]], non-specific ailments can be treated in non-specific ways with non-specific results.
{{Clearleft}}

===Cancer woo===

Many vitamin peddlers make unproven health claims about dietary supplements curing cancer. In reality, there is no scientific evidence that any dietary supplement can cure or treat cancer. Currently, the only dietary supplement that may reduce bowel cancer risk is calcium supplements.<ref name="Australia"/><ref>[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003548.pub4/full Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps]. cochranelibrary.com.</ref><ref name="wcrf">[https://www.wcrf.org/diet-activity-and-cancer/risk-factors/vitamins-minerals-and-other-nutrients-and-cancer-risk/ Vitamins, minerals and other nutrients and cancer risk]. wcrf.org.</ref> However, cancer authorities do not advocate the use of calcium supplements, as it is best to eat a healthy diet rather than rely on dietary supplements to reduce risk of cancer.<ref name="wcrf"/>

==Efficacy and safety==
===Vitamin A/''beta''-carotene===
[[File:All-trans-Retinol2.svg|thumb|right|165px|Retinol (one form of vitamin A)]]
Vitamin A deficiencies can occur in developing nations and can lead to severe visual problems, among other conditions; with 200 million children affected by this deficiency (causing half a million deaths and another half a million cases of permanent blindness), this may be the most widespread deficiency.<ref>[https://web.archive.org/web/20140130054855/http://www.who.int/vmnis/database/vitamina/x/en/ WHO on Vitamin A deficiency]</ref> ''Beta''-carotene (β-carotene), a common precursor to Vitamin A used as a supplement, has been studied as an "antioxidant" and [[cancer]] preventative. However, large, well-conducted studies have shown an increase in lung cancer in people taking these supplements. Smokers and others at increased risk for lung cancer saw their risk increase even more.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/8901853 Risk Factors for Lung Cancer and for Intervention Effects in CARET, the Beta-Carotene and Retinol Efficacy Trial] by Gilbert S. Omenn et al. (1996). ''Journal of the National Cancer Institute'' 88(21):1550-1559.</ref> Another recent study showed an increase in aggressive prostate cancers in men taking ''beta''-carotene.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/17507623 Serum Lycopene, Other Carotenoids, and Prostate Cancer Risk: a Nested Case-Control Study in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial] by Ulrike Peters et al. (2007) ''Cancer Epidemiol. Biomarkers Prev.'' 16: 962-968 doi: 10.1158/1055-9965.EPI-06-0861</ref>

Excess vitamin A is stored is stored in the liver, although there is a limit.  β-carotene is stored in your fat cells, and is converted to vitamin A when needed.  So long as sufficient amounts existed in storage beforehand, humans can survive for several months without vitamin A before malnutrition sets in.

Since Vitamin A derives from ''beta''-carotene, a {{wpl|carotenoid}} pigment, massive overdoses of either substance can turn the consumer's skin yellow or orange. Also, both substances are closely related to {{wpl|retinoid}} pigments such as form the photosensitive component of most animal eyes. Such substances are also used in medicine to treat severe skin diseases such as disfiguring acne and ichthyosis; however, they can be {{wpl|Teratogen|teratogens}} due to their effect on [[DNA]], requiring careful monitoring, especially in female patients.

Unlike ''beta''-carotene, vitamin A in retinoid form is not water-soluble, so excesses cannot be easily excreted through the kidneys (unlike vitamin C). Thus, serious health complications can arise from taking too much of it (c.f. {{wpl|Hypervitaminosis A}}). This is why you shouldn't eat polar bear liver.

===B-vitamins===
[[File:Niacin structure.svg|thumb|right|165px|Niacin (vitamin B<sub>3</sub>)]]
* Vitamin B<sub>9</sub>, or folate, is necessary for several metabolic pathways in cells, including those involved in DNA replication. Deficency can lead to anemia, and, more critically, {{wpl|neural tube defect||s}} in fetuses, because folate deficiency interferes with proper cell division. This has led to legally-mandated folate fortification of foods in the U.S. and many other countries.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/00039032.htm Knowledge and Use of Folic Acid by Women of Childbearing Age &mdash; United States, 1995] ''MMWR Weekly'' September 29, 1995 / 44(38);716-8.</ref> Because of this risk of birth defects, the U.S. National Academy of Medicine recommends that anyone planning to become pregnant consume a minimum of 400 mcg/day from supplements or fortified foods, and consume at least 600 mcg/day during pregnancy.<ref name=NIH2016>{{cite web|publisher=National Institutes of Health|title=Fact Sheet for Health Professionals – Folate|url=http://ods.od.nih.gov/factsheets/folate/|url-status=live|archive-url=https://web.archive.org/web/20110402200837/http://ods.od.nih.gov/factsheets/Folate/|archive-date=2 April 2011|df=dmy-all}}</ref> The American College of Obstetricians and Gynecologists recommends that all people pregnant or capable of becoming pregnant take a daily vitamin supplement that includes at least 400 mcg of B<sub>9</sub>.<ref>[https://web.archive.org/web/20131116120450/http://www.acog.org/~/media/For%20Patients/faq001.pdf?dmc=1&ts=20120515T1154495022 FAQ], The American College of Obstetricians and Gynecologists</ref> High {{wpl|homocysteine}} levels in adults are associated with heart disease, and can be reduced by adequate folate intake,<ref>[https://www.ncbi.nlm.nih.gov/pubmed/9535670 Homocysteine and atherothrombosis] by G.N. Welch & J. Loscalzo (1998) ''N. Engl. J. Med.'' 338:1042-1050.</ref> although it has not been shown that taking folic acid reduces cardiac risk.

* A deficiency of Vitamin B<sub>1</sub>, called "thiamine", can result in ''beriberi.'' In the developed world this is most commonly seen in people who have a long history of chronic [[alcohol]] or other substance abuse, and in places dependent on rice it can be largely prevented by eating it unpolished.

* A deficiency of Vitamin B<sub>2</sub>, called "riboflavin", can result in ''ariboflavinosis''. However, riboflavin deficiency is always accompanied by deficiency of other vitamins.<ref name=Brody>''Nutritional Biochemistry'' by Tom Brody (1998). Academic Press, 2<sup>nd</sup> ed. ISBN 0121348369.</ref>

* A deficiency of Vitamin B<sub>3</sub>, called "niacin", can result in ''pellagra'' (the first disease described using the modern scientific method, although it wasn't until later that they discovered the cause). A lack of {{wpl|tryptophan||,}} which the body converts to niacin, can have the same effect; the genetic disorder {{wpl|Hartnup syndrome||}} somewhat (though not entirely) inhibits the conversion of tryptophan to niacin, while {{wpl|carcinoid syndrome||}} causes the body to convert abnormal amounts of tryptophan into serotonin instead of niacin. Pellagra was rampant in [[the South]] well into the 20<sup>th</sup> century, but is now exceedingly rare in the developed world thanks to vitamin fortifications (a.k.a., supplementation) in food (in the US, bread and enriched rice/flour). Although the US RDA of niacin is 20 mg per day, niacin is increasingly being prescribed at therapeutic dosage levels (upwards of 1000 mg per day) as a treatment for elevated blood triglycerides. Unfortunately, large doses of niacin can result in uncomfortable flushing episodes; these can be managed by taking aspirin half an hour before taking niacin or sometimes by just eating a meal first. "No flush" versions of niacin exist, but these have been demonstrated ''not'' to have an effect on blood triglycerides and thus kinda defeat their own purpose.

*Vitamin B<sub>12</sub> deficiency—usually from an improperly-managed vegetarian or vegan diet, certain intestinal diseases, heavy abuse of nitrous oxide (laughing gas/whippets/nangs),<ref>Edigin E, Ajiboye O, Nathani A (August 06, 2019) Nitrous Oxide-induced B12 Deficiency Presenting With Myeloneuropathy. Cureus 11(8): e5331. doi:10.7759/cureus.5331</ref> or ''pernicious anemia''—is fairly rare, and when it exists, it must be treated. A B<sub>12</sub> deficiency can lead to symptoms like tingling in hands or feet, difficulty walking, tongue inflammation, cognitive difficulties, fatigue, and weakness; supplements can treat this.<ref>[https://www.health.harvard.edu/blog/vitamin-b12-deficiency-can-be-sneaky-harmful-201301105780 Vitamin B12 deficiency can be sneaky, harmful] - Harvard Medical School</ref> Supplementing this vitamin in non-deficient people has not shown to have any benefit, but oral supplementation as part of a daily multivitamin may have a small effect of reducing cardiac risk in some people. Deficiency is more common in older people, as they tend to become less able to absorb vitamin B<sub>12</sub> in foods, and some medications can interfere with its absorption. "Because 10 to 30 percent of older people may malabsorb food-bound B<sub>12</sub>, it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with B<sub>12</sub> or a supplement containing B<sub>12</sub>."<ref>[http://www.sciencedirect.com/science/article/pii/S0085253815469236 Vitamin status and intake as primary determinants of homocysteinemia in an elderly population] by J. Selhub et al. ''JAMA'' 1993;270:2693-2698</ref><ref name=ods>[https://ods.od.nih.gov/Health_Information/Dietary_Reference_Intakes.aspx ''Nutrient Recommendations: Dietary Reference Intakes (DRI)''] National Institutes of Health Office of Dietary Supplements (2011).</ref> B<sub>12</sub> is only found in reliable amounts in animal foods; thus, the U.S. Academy of Nutrition and Dietetics recommends that vegetarians and vegans fulfill their nutritional requirement for B<sub>12</sub> through consumption of supplemental B<sub>12</sub> or foods fortified with the vitamin.<ref>{{cite journal|vauthors=Melina V, Craig W, Levin S| title=Position of the Academy of Nutrition and Dietetics: Vegetarian Diets|journal=J Acad Nutr Diet|year=2016|volume=116|issue=12|pages=1970–1980|pmid=27886704|doi=10.1016/j.jand.2016.09.025|url=https://web.archive.org/web/20161202165753/http://www.eatrightpro.org/~/media/eatrightpro%20files/practice/position%20and%20practice%20papers/position%20papers/vegetarian-diet.ashx}}</ref>

**B<sub>12</sub> deficiency leads to anemia, neuropathy, particularly in the hands and feet, and in severe cases cardiomyopathy, neurological symptoms, infertilty, and growth retardation in children. If you suspect a deficiency, pick up some supplements right away and then make a doctor appointment. The good news is that early treatment makes a big difference.<ref>[https://www.medicalnewstoday.com/articles/324265 What are the symptoms of vitamin B-12 deficiency?] - Medical News Today</ref>

*Folate, B<sub>12</sub>, and B<sub>6</sub> are sometimes recommended for memory, but studies have failed to show any benefit in non-deficient individuals.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/17210874 Vitamin B<sub>6</sub>, B<sub>12</sub> and folic acid supplementation and cognitive function: a systematic review of randomized trials] by E. M. Balk et al. ''Archives of Internal Medicine''. 167(1):21-30, 2007 Jan 8.</ref> "In view of evidence linking folate intake with neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant consume 400μg from supplements or fortified foods in addition to intake of food folate from a varied diet."<ref name=ods/>

*Vitamin B<sub>6</sub> very rarely requires supplementation in the typical American diet.<ref>What Vitamins Should I Be Taking, Doctor? Willett WC, Stampfer MJ. ''N. Engl. J. Med.'' 345:1819, December 20, 2001.</ref> Certain medications can cause deficiency, as can consumption of {{wpl|ginkgo biloba}} seeds.

===Vitamin C===
{{main|Vitamin C}}
[[File:L-Ascorbic acid.svg|thumb|right|165px|L-Ascorbic acid (Vitamin C)]]
Vitamin C may have the most notoriety of the commonly available vitamin supplements due to [[Nobel Prize]]-winning biochemist [[Linus Pauling]]'s 
wacko
 controversial assertions that large doses of vitamin C can prevent the common cold, a position that a) showed that even [[Nobel disease|Nobel Prize winners can be wrong]], egregiously wrong, and b) proved to be not terribly accurate when studied but very persistent in the journals of public opinion, probably due to a lack of [[peer review]] in that forum.

Vitamin C deficiency leads to ''scurvy'' (from which the name ''ascorbic acid'' derives), which was a massive problem for early sailors. In the developed world, this still needs to be accounted for when planning extended trips without access to fresh food, such as long-term submarine missions. In addition to its usual function, vitamin C is also used as a preservative for fresh fruit (especially apples, where it prevents enzymatic browning after the fruit is cut). Food scientist and cookbook author Shirley Corriher, in her 1997 kitchen science book ''Cookwise'', also recommends adding vitamin C to some bread recipes to enhance gluten development.

Proponents of [[Orthomolecular medicine]] believe that Vitamin C supplements can cure cancer. This is not supported by clinical evidence. A 2018 review noted that "results from most clinical trials suggest that modest vitamin C supplementation alone or with other nutrients offers no benefit in the prevention of cancer."<ref>https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/</ref>

Like vitamin D and unlike the vast majority of other woo supplements and herbs, vitamin C is a serious supplement for asymptomatic people. Having extra vitamin C is not just superfluous, it has theoretical mechanisms and even evolutionary arguments for why it should help, which is why Pauling stuck so strongly to it. In a way, the question is why taking a lot more doesn't help human health, not why it should. It's useful for conditions like pneumonia when a patient's vitamin C levels are severely depleted and has been suggested as a cheap prophylactic measure in people at high risk from pneumonia. It has been shown to help against the original SARS virus of 2002-2004 and has been tried intravenously by a [[New York]] doctor against [[COVID-19]], who has claimed modest benefits. On the other hand, it has been tried and tried and just does not work against cancer, aging and other diseases, especially not orally and when a disease has taken hold. Whether you're an idiot for taking it as a healthy person or not is up for question but certainly when COVID-19 is hanging around it's a highly plausible supplement to take, especially if you're a vulnerable person. 

Like vitamin E and ''beta''-carotene, vitamin C is an [[antioxidant]].

===Vitamin D===
{{main|Vitamin D}}
[[File:Cholecalciferol2.svg|thumb|right|165px|Cholecalciferol (Vitamin D<sub>3</sub>)]]
Vitamin D is especially important for bones. There is evidence that people who live in cooler, cloudier climates, where sun exposure is less, benefit from some supplementation.<ref>Thomas MK, Lloyd-Jones DM, Thadhani RI, et al. Hypovitaminosis D in medical inpatients. ''N. Engl. J. Med.'' 1998;338:777-783.</ref> Without adequate vitamin D, the body absorbs no more than 10%-15% of dietary calcium. In the vitamin D–sufficient state, calcium absorption increases to 30% to 40%.<ref>Khazai N, Judd SE, Tangpricha V. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669834/ ''Calcium and vitamin D: skeletal and extraskeletal health'']. Curr Rheumatol Rep. 2008 Apr;10(2):110-7.</ref>

Recent studies have also shown that Vitamin D also works as a hormone to help regulate important functions of the body. One study showed an association between excessive daytime sleepiness and low levels of Vitamin D.<ref>[http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=28731 Vitamin D, Race, and Excessive Daytime Sleepiness] by David E. McCarty et al. (2012) ''Journal of Clinical Sleep Medicine'' 8(6):693-697.</ref> New research suggests that Vitamin D may play a significant role in the prevention and treatment of type 1 and type 2 diabetes, hypertension, glucose intolerance, multiple sclerosis, and other medical conditions.<ref name="factsheet_vitD">[https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h7 Vitamin D Fact Sheet for Health Professionals]</ref>

The Endocrine Society 2011 clinical guidelines for vitamin D, states that that to maximize effect on calcium, bone, and muscle metabolism the desirable serum concentration of 25(OH)D is >75 nmol/L (>30 ng/ml).<ref name="factsheet_vitD"/>

Vitamin D is fat-soluble; the body stores it in liver and fat tissue. Serum 25(OH)D levels increase in response to increased vitamin D intake, but however the relationship is non-linear, so that increasing serum 25(OH)D to >50 nmol/L requires much more vitamin D than increasing levels from a baseline <50 nmol/L.<ref name="factsheet_vitD"/>

===Vitamin E===
[[File:Alpha-Tocopherol Structural Formulae V.1.svg|thumb|right|165px|α-Tocopherol (one form of vitamin E)]]
According to the first edition of Harold McGee's seminal kitchen-science book ''On Food and Cooking'', Vitamin E deficiencies are not especially common in the Western diet.<ref>'On Food and Cooking'' by Harold McGee (1997). Scribner. 1<sup>st</sup> ed. ISBN 0684843285.  p. 539</ref> Almost all cases in the developed world are completely unrelated to quality of food intake and mostly occur in very small and premature infants, people with a specific genetic disorder that severely inhibits Vitamin E absorption, and people who have various metabolic or gastrointestinal disorders (e.g. {{wpl|Crohn's disease}}) which result in difficulty absorbing fat from their diets. However, supplements are sold and sometimes used as skin care lotions. Vitamin E is also sometimes used as a preservative for whole grain products.

Note: ''"… researchers from the Cleveland Clinic found that men who took vitamin E had an increased risk of prostate cancer."''<ref>[https://web.archive.org/web/20111017200122/http://my.clevelandclinic.org/media_relations/library/2011/2011-10-11-national-study-finds-vitamin-e-supplement-may-increase-prostate-cancer-risk.aspx National Study Finds Vitamin E Supplement May Increase Prostate Cancer Risk] (October 11, 2011) ''Cleveland Clinic''.</ref> The US Preventive Services Task Force issued a statement in 2022 recommending against the use of beta carotene and vitamin E supplements for the prevention of cardiovascular disease or cancer.<ref>[https://jamanetwork.com/journals/jama/fullarticle/2793446 Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement]</ref> Vitamin E is sometimes suggested to treat Peyronie's Disease<ref>[https://www.advancedurologyinstitute.com/effective-treat-peyronies-disease/]</ref> and Dupuytren's disease<ref>[https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1200-y]</ref>, though studies differ on their effectiveness.

Like vitamin C and ''beta''-carotene, vitamin E is an [[antioxidant]].

===Vitamin K===
{{hatnote|Not to be confused with [[Near-death experience#Ketamine|ketamine]], which has been referred to in slang as 'Vitamin K'.''}}
[[File:Phyllochinon.svg|thumb|right|165px|Phylloquinone (Vitamin K<sub>1</sub>)]]
Vitamin K (from the German ''Koagulationsvitamin'') is used in the human body's blood clotting system and calcium deposition. Most people get a sufficient amount of it from [[bacteria]] in the colon and from virtually any leafy vegetable such as spinach or kale, and it is not widely available as a standalone supplement for adults. Insufficient Vitamin K can lead to arteriosclerosis (i.e. calcium being deposited not in the bones but instead in the walls of arteries in the heart and lungs).{{fact}} It is contraindicated for those on long-term anticoagulant therapy (warfarin or similar drugs) and is useful in the treatment of rat poison (warfarin) ingestion.

Because babies are born low in vitamin K — it does not cross the placenta well, it is not significantly present in breastmilk, and newborns do not have much of a gut microbiome — babies in developed countries routinely receive vitamin K injections shortly after birth to reduce the risk of hemorrhages, e.g. into the GI tract or brain.<ref>[https://web.archive.org/web/20200715041029/https://www.cdc.gov/ncbddd/vitamink/vitamin-k-fact-sheet-general.html Protect Your Baby From Bleeds — Talk to Your Healthcare Provider about Vitamin K] (December 26, 2019) ''Centers for Disease Control and Prevention''.</ref>  Comporting with their general [[Chemophobia|chemophobia]] and 
terror of anything that comes in a syringe
 misplaced suspicion of proven-safe public health measures, [[Anti-vaccination movement|anti-vaxxers]] and [[Joseph Mercola|some figures]] in [[Alternative medicine|alternative medicine]] have begun [[Fear, uncertainty, and doubt|fearmongering]] about these injections as well, with the predictable sequelae of parents refusing them and newborns getting hurt.<ref> [https://www.thedailybeast.com/anti-vaxxers-turn-on-vitamins-too Anti-Vaxxers Turn on Vitamins, Too] (April 14, 2017) ''The Daily Beast''.</ref>

===Minerals===
Dietary minerals, such as phosphorus, magnesium, zinc, and kryptonite,{{lie}} aren't classified as vitamins. However, many multivitamin supplements also include some minerals.

Several [[snake oil]] salesmen over the years have pushed mineral supplements. Sales pitches such as the audio/video/book ''Dead Doctors Don't Lie'',<ref>[http://www.skepdic.com/wallach.html Joel D. Wallach, the "mineral doctor"] The Skeptic's Dictionary</ref><ref>''Dead Doctors Don't Lie'' by Joel D. Wallach (2004) Wellness Publications, 2<sup>nd</sup> ed. ISBN 0974858102.</ref> [[colloidal silver]], and more recently, [[Miracle Mineral Supplement]], tout their mineral supplements as the cure for everything from aging to prostate cancer. Generally these high-priced mineral supplements are in some form you can't get from your local drugstore, such as colloidal suspensions, accompanied by claims that their form is much better absorbed than the normal pills are. At best, these mineral supplements will give you very expensive urine. At worst, they can cause serious side effects in sufficient quantities. For example, colloidal silver can cause the skin to become blue-gray, and excessive zinc supplementation can cause copper deficiency.

===Pseudovitamins===
{{main|Pseudovitamin}}
A number of substances are sold with a false claim to be vitamins. These are often named using the "vitamin" naming convention, as in "Vitamin B<sub>17</sub>" (which is actually [[laetrile]]). A number of substances were once thought to be vitamins but later reclassified out of the vitamin category; occasionally one will still run across these being referred to using their old (generally pre-[[World War II]]) vitamin name, such as "Vitamin F" and "Vitamin B<sub>4</sub>". "Vitamin F" was the old name for essential fatty acids, which are essential for human nutrition but do not meet the definition of a vitamin any more than [[water]] does. "Vitamin B<sub>4</sub>" is adenine, which is no longer considered a vitamin as it is not necessary for human nutrition, although it is synthesized in the body and binds with 
other
 B vitamins. Taking any of these supplements is a waste of money, and in the case of "B<sub>17</sub>"/laetrile, can be hazardous to your health.

===National bans on vitamin supplements===
[[Denmark]] bans the sale of products with excessive amounts of vitamins, believing them to be a health risk.<ref>[http://www.nytimes.com/2011/06/17/world/europe/17copenhagen.html Extra Vitamins? A Great Idea, Except in Denmark] (Jun 16, 2011) ''New York Times''.</ref>

==Megavitamin therapy==
Megavitamin therapy is 
what Dr. Mario uses to get rid of viruses<ref>[https://www.nintendo.co.jp/clv/manuals/en/pdf/CLV-P-NAAXE.pdf Dr. Mario Instruction Booklet] ''[[Nintendo]]''. Warning: this does not work in the [[real world]].</ref>
 the use of large doses of vitamins (or minerals), exceeding the recommended dose range, and even exceeding maximum safe dose, dose levels that have been created by [[scientific consensus]]. As such, megavitamin therapy usually falls into the realms of [[quackery]] and [[alternative medicine]], and only rarely in the realm of experimental medicine. Megavitamin therapy is common in [[orthomolecular medicine]]<ref>Orthomolecular therapy: its history and applicability to psychiatric disorders by F. J. Menolascino et al. (1988). ''Child Psychiatry Hum. Dev.'' 18 (3): 133–50. doi:10.1007/BF00709727.</ref> and [[naturopathy]], but is only rarely used in regular medicine for unusual genetic diseases.<ref>[http://ajcn.nutrition.org/content/75/4/616.long High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased ''K<sub>m</sub>''): relevance to genetic disease and polymorphisms<sup>1-3</sup>] by B. N. Ames et al. (2002). ''Am. J. Clin. Nutr.'' 75 (4): 616–58. PMID 11916749.</ref>

The first research on megavitamin therapy begin in the 1930s: for vitamin E by Drs. Wilfrid and Evan Shute (1936),<ref>[http://www.doctoryourself.com/estory.htm The Vitamin E Story] DoctorYourself.com</ref> for vitamin C by Claus W. Jungeblut in 1937,<ref>[http://jem.rupress.org/content/65/1/127 Vitamin C therapy and prophylaxis in experimental poliomyelitis] by Claus W. Jungeblut (1937) ''Journal of Experimental Medicine'' 66(1):127.</ref> and for vitamin B<sub>3</sub> by W. Kaufman in 1953.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/13060032 Niacinamide therapy for joint mobility; therapeutic reversal of a common clinical manifestation of the normal aging process] by W. Kaufman (1953) ''Conn. State Med. J.'' 17(7):584-9.</ref>

The Dietary Reference Intakes (DRIs) and Tolerable Upper Intake Level (ULs) below are per day for adult males (M) and non-pregnant, non-lactating adult females (F). These values and adverse effects are taken from the ''Nutrient Recommendations: Dietary Reference Intakes''.<ref name=ods/> See the original document for children's and other adult females' levels.

Depending on the vitamin, DRIs are either Recommended Dietary Allowances (RDAs) or Adequate Intakes (AIs). RDAs are the "average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy people."<ref name=ods/> AIs are "established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy."<ref name=ods/> The Tolerable Upper Intake Level (UL) "is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects in almost all individuals."<ref name=ods/> These levels are the total intake from all sources (except for magnesium, as noted in the table): dietary, [[Sun]] exposure (for vitamin D), and nutritional supplements.

Just because there is a UL for a given nutrient, it does not mean that there is necessarily any benefit in consuming at or near that amount. High dose [[antioxidant]] pills appear to be worse than useless (and some vitamins are antioxidants). Yes, that's right, '''antioxidants can hinder muscle strength'''. This appears to be because muscles require a certain level of oxidative stress in order to build over time.<ref>[https://www.sciencenews.org/article/athletes-antioxidant-pills-may-not-help-performance For athletes, antioxidant pills may not help performance: Some supplements can blunt the positive effects of exercise training] by Laura Beil (February 24, 2015) ''Science News''.</ref>

It should be of particular concern for users of megadose mineral supplements that the consumption of mineral supplements was correlated with higher doses of minerals from food sources, particularly for calcium and magnesium.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192481/ Dietary supplement use is associated with higher intakes of minerals from food sources] by Regan L. Bailey et al. ''Am. J. Clin. Nutr.'' 2011 Nov; 94(5): 1376–1381. Published online 2011 Sep 28. doi:  10.3945/ajcn.111.020289.</ref>

{|class="wikitable"
!|Micronutrient
!|Dietary Reference Intakes (DRI)<ref name=ods/><ref group=note name=range>When a range of values is given, it means that different DRIs are given for different adult age ranges</ref>
!|Potential adverse effects below DRI<ref name=ods/><ref group=note name=adverse>This is not necessarily an exhaustive list.</ref>
!|Tolerable Upper Intake Level (UL)<ref name=ods/><ref group=note name=range/>
!|Potential adverse effects above UL<ref name=ods/><ref group=note name=adverse/>
!|People who have taken more than the UL and/or recommendations at/above the UL
|-
|colspan=6|<center>'''Vitamins'''</center>
|-
|Vitamin A
|900 µg (M);<BR>700 µg (F)
|Xerophthalmia, impaired embryonic development, follicular hyperkeratosis, increased risk of infectious morbidity and mortality
|3000 µg
|Bone mineral density loss, teratogenicity, liver abnormalities, vision trouble, skin peeling off
|
*Some supplements are at the UL (e.g., "GNC Vitamin A 10000 IU"<ref>[https://web.archive.org/web/20141221055520/http://www.gnc.com/GNC-Vitamin-A-10000-IU/product.jsp?productId=16153416 Vitamin A 10000 IU] GNC</ref>). 10,000 IU from fish liver oil (retinol) is 3000 µg.<ref name=iu>[https://web.archive.org/web/20170314174256/http://rfaregulatoryaffairs.com/images/pdfs/vitamin_conversion.pdf RFA Vitamin Conversion Chart] Robert Forbes and Associates Regulatory Affairs</ref> Unless one's diet is otherwise totally devoid of vitamin A, taking this as directed will push one over the UL.
*[[Scientology]]/[[Narconon]]'s "Purification Rundown" includes doses of vitamin A at 5,000-50,000 IU<ref name=exposed>[https://www.cs.cmu.edu/~dst/Narconon/detox.htm Is Narconon Safe? Dangerous detoxification] by Chris Owen (5 November 2002) ''Narconon Exposed''.</ref> Depending on the form of vitamin A, this could range from 1,500-15,000 µg to 2,750-27,500µg.<ref name=iu/>
*A [[paleo diet]] book co-authored by [[Pete Evans]] titled ''Bubba Yum Yum: The Paleo Way for New Mums, Babies & Toddlers'' contains a recipe that is "10 times the maximum safe daily intake of vitamin A for babies."<ref>[https://www.theguardian.com/australia-news/2015/mar/12/pete-evans-paleo-for-kids-cookbook-put-on-hold-amid-health-concerns Pete Evans paleo for kids cookbook put on hold amid health concerns: Public Health Association president says recipe in book co-authored by celebrity chef has 10 times safe daily intake of vitamin A for babies] by Melissa Davey (12 Mar 2015 01.37 EDT) ''The Guardian''.</ref>{{efn|Pan Macmillan Australia originally planned to publish the book (ISBN 1743537042), but completely dropped Evans as an author after he posted a cartoon on [[Facebook]] showing an ancient {{wpl|Black Sun (symbol)|Sonnenrad symbol}} that has been coopted by [[neo-Nazis]] (Evans is a [[Donald Trump|Trump]] supporter, so connect the dots).<ref>[https://www.bandt.com.au/pan-macmillan-drops-pete-evans-amid-neo-nazi-scandal-as-10-boots-him-from-im-a-celeb-line-up/ Pan Macmillan Drops Pete Evans Amid Neo-Nazi Scandal, As 10 Boots Him from ''I'm a Celeb'' Line-up] (17 November, 2020)''B&T Magazine''.</ref> An earlier edition of the book was self-published by one of the co-authors.<ref>''Bubba Yum Yum: The Paleo Way for New Mums, Babies & Toddlers'' by Charlotte Carr, Helen Padarin, and Pete Evans (2015) Charlotte Carr. ISBN 0994326408.</ref>}}
|-
|[[Vitamin C]]
|90 mg (M);<BR>75 mg (F)
|Scurvy, dyspnea, edema, Sjögren's syndrome, weakness, fatigue, depression
|2000 mg
|Gastrointestinal disturbances, increased oxalate excretion and kidney stone formation, increased uric acid excretion, excess iron absorption, lowered vitamin B<sub>12</sub> levels, systemic conditioning, pro-oxidant effects
|
*Prior to 1999, Dr. [[Andrew Weil]] recommended 2000-6000 mg, since then he only recommends 200 mg<ref name=weil>[https://www.drweil.com/vitamins-supplements-herbs/vitamins/overloading-on-vitamin-c/ Overloading on Vitamin C?] (March 16, 2009) ''Weil''.</ref>
*[[Linus Pauling]] took 18,000 mg.<ref name=weil/>
*{{wpl|Andrew Saul (nutrition)|Andrew W. Saul,}} a [[nutritionist]] involved in orthomolecular medicine recommends 15,000 mg or more.<ref>[http://fatburningman.com/dr-andrew-saul-the-megavitamin-man-high-dose-vitamin-c-diy-health/ Dr. Andrew Saul: The MegaVitamin Man, High-Dose Vitamin C, & DIY Health] interview with Abel James (Last Updated: October 26, 2015) ''Fat-Burning Man''.</ref>
*Robert F. Cathcart, M.D. recommended up to 200,000 mg/day to "provide the reducing equivalents necessary to quench almost all the free radicals generated by severe disease processes."<ref>[http://archive.ph/4nDl2 The Third Face of Vitamin C] by Robert F. Cathcart, ''Journal of Orthomolecular Medicine'', 7:4;197-200, 1993.</ref>
*Some supplements are at the UL (e.g., "GNC Vitamin C 2000 MG &mdash; Crystals"; recommended dose is 1/2 teaspoon = 2000 mg<ref>[https://web.archive.org/web/20140423095409/http://www.gnc.com/GNC-Vitamin-C-2000-MG-Crystals/product.jsp?productId=16513106 GNC Vitamin C 2000 MG &mdash; Crystals] GNC</ref>). Unless one's diet is otherwise totally devoid of vitamin C, taking this as directed will push one over the UL.
*Scientology/Narconon's "Purification Rundown" includes of doses of up to 6000 mg of vitamin C.<ref name=exposed/>
*It has been claimed that taking 2000 mg/day of vitamin C can reduce the duration of the common cold,<ref>[https://examine.com/supplements/vitamin-c/ Vitamin C] Examine.com</ref> however vitamin C supplementation does not reduce the incidence of colds.<ref name=hemila>[http://www.mv.helsinki.fi/home/hemila/CC/CC.htm Vitamin C for preventing and treating the common cold] by Harri Hemilä & Elizabeth Chalker (2013). ''Cochrane Database of Systematic Reviews'', Issue 1. Art. No.: CD000980. DOI:10.1002/14651858.CD000980.pub4.</ref> The evidence for reducing the duration of colds is based on individuals who experienced "extreme physical stress", not the general population.<ref name=hemila/> The evidence for reducing the duration of colds was also not [[replicate]]d in therapeutic trials, and the authors of the [[meta-analysis]] concluded that the "level of benefit does not justify long-term supplementation" for colds.<ref name=hemila/>
*[[CEASE therapy]] — a [[pseudoscience]] for treating [[autism]]
|-
|[[Vitamin D]]
|15-20 µg (M);<BR>25-20 µg (F)<BR>= 600-800 IU
|Rickets/osteomalacia, bone fracture, inadequate calcium absorption, Colon/Prostate/Breast cancer. Diabetes Type 1 & 2, Hypertension, Glucose intolerance, Multiple Sclerosis
|100 µg (M); 100 µg (F)<BR>=4000 IU
|Hypercalcemia
|
*Some supplements are at the UL (e.g., "Carlson® Vitamin D3 &mdash; 4000 IU"<ref>[http://archive.ph/wjRWI Carlson® Vitamin D3 &mdash; 4000 IU] GNC (archived from February 27, 2017)</ref>). Unless one spend one's whole life in a [[Argumentum ad cellarium|basement]], taking this as directed will put one over the UL.
*[[Joseph Mercola]]'s "Liposomal Vitamin D 5000 IU" is above the UL.<ref>[https://archive.ph/3wjsf Liposomal Vitamin D 5000 IU (30 per bottle): 30 Day Supply] Dr. Mercola Premium Products</ref>
*Ortho Molecular Products' "Vitamin D 5,000 IU" is also above the UL<ref>[https://web.archive.org/web/20141225065718/http://www.orthomolecularproducts.com/vitamin-d-5-000-iu/ Vitamin D 5,000 IU] Ortho Molecular Products</ref>
*Suzy Cohen's Vitamin D3 contains 5000 IU per serving<ref>[http://archive.ph/qxPu9 Vitamin D3 in EVOO] (Suzy Cohen) (archived from June 7, 2017)</ref>
|-
|Vitamin E
|15 mg (M);<BR>15 mg (F)
|Peripheral neuropathy, spinocerebellar ataxia, skeletal myopathy, pigmented & retinopathy, but "overt deficiency symptoms in normal individuals consuming diets low in vitamin E have never been described."
|1000 mg
|Hemorrhagic toxicity, inhibition of blood platelet effects
|
*The so-called "Shutes Protocol"<ref>[https://www.ncbi.nlm.nih.gov/pubmed/18911314 Some medical uses of vitamin E] by A. Vogelsang, E. Shute & W. Shute (1948) ''Med. World'' 161(2):83-9.</ref> includes doses of up to 1600 IU (1072-1440 mg depending on the type of vitamin E).<ref name=iu/> Treatment at this level has been suggested for a variety of ailments, including thrombosis, angina, burns, plastic surgery, and mazoplasia.<ref>[http://www.doctoryourself.com/shute_protocol.html Shute Vitamin E Treatment Protocol] DoctorYourself.com</ref>
*Scientology/Narconon's "Purification Rundown" includes of doses of up to 2400 IU of vitamin E.<ref name=exposed/> Depending on the form of vitamin E, this would be in the range of 1610-2690 µg.<ref name=iu/>
|-
|Vitamin K
|120 µg (M);<BR>90 µg (F)
|Hypoprothrombinemia, increase in prothrombin time, bleeding, Arteriosclerosis
|none established
|
|
|-
|Thiamin (B<sub>1</sub>)
|1.2 mg (M);<BR>1.1 mg (F)
|anorexia, weight loss, apathy, decrease in short-term memory, confusion, irritability, muscle weakness, cardiovascular effects such as an enlarged heart
|none established
|
|
|-
|Riboflavin (B<sub>2</sub>)
|1.3 mg (M);<BR>1.1 mg (F)
|sore throat, hyperemia, edema of the pharyngeal & oral mucous membranes, cheilosis, angular stomatitis, glossitis (magenta tongue), seborrheic dermatitis, normochromic, anemia
|none established
|
|
|-
||Niacin (B<sub>3</sub>)
|16 mg (M);<BR>14 mg (F)
|Pellagra, vomiting, constipation or diarrhea, bright red tongue, neurological symptoms
|35 mg
|Vasodilatory effects (flushing), gastrointestinal effects, hepatotoxicity, glucose intolerance, ocular effects
|
*Scientology/Narconon's "Purification Rundown" includes of doses of niacin ranging from 100 mg up to 5000 mg.<ref>[http://web.archive.org/web/20090712062312/http://www.nypress.com/article-16488-the-rundown-on-scientologys-purification-rundown.html The Rundown on Scientology's Purification Rundown: What Scientologists aren't telling you about their detox program] (June 6,2007) ''New York Press'' (archived copy from July 12, 2009).</ref><ref name=exposed/>
*Joseph Mercola's Whole-Food Multivitamin Plus Vital Minerals is above the UL at 40 mg
|-
|B<sub>6</sub>
|1.3-1.7 mg (M);<BR>1.3-1.5 mg (F)
|Seborrheic dermatitis, microcytic anemia, epileptiform convulsions, depression, confusion
|100 mg
|Lung cancer (>20 mg), sensory neuropathy
|
*Some supplements are at the UL (e.g., "Nature Made B-6 Vitamin 100 mg"<ref>[http://www.target.com/p/nature-made-b-6-100mg-tablets-100-count/-/A-11010212 Nature Made B-6 Vitamin 100 mg] Target</ref>). Unless one's diet is otherwise totally devoid of B<sub>6</sub>, taking this as directed will push one over the UL.
*A large prospective epidemiology study found an increased risk of lung cancer for both smoking and non-smoking men (but not women) in those groups taking the highest doses of B<sub>6</sub> (>20 mg), but not lower dose groups.<ref name=osu>[https://cancer.osu.edu/news-and-media/news/long-term-high-dose-vitamin-b6-b12-use-associated-with-increased-lung-cancer-risk-among-men Long-Term, High-Dose Vitamin B<sub>6</sub>/B<sub>12</sub> Use Associated With Increased Lung Cancer Risk Among Men] (August 22, 2017) Ohio State University Comprehensive Cancer Center</ref><ref name=brasky>[http://ascopubs.org/doi/10.1200/JCO.2017.72.7735 Long-Term, Supplemental, One-Carbon Metabolism–Related Vitamin B Use in Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort] by Theodore M. Brasky et al. (2017) ''Journal of Clinical Oncology'' JCO.2017.72.773 DOI: 10.1200/JCO.2017.72.7735</ref>
|-
|Folate (B<sub>9</sub>)
|400 µg (M);<BR>400 µg (F)
|Neural tube defects, other congenital anomalies, vascular disease; cancer, psychiatric and mental disorders
|1000 µg
|Neuropathy
|
*Some supplements are at the UL (e.g., "PureFormulas Methyl Folate 1,000 mcg"<ref>[https://web.archive.org/web/20121018052150/http://pureformulas.com/methyl-folate-l5mthf-60-tablets-by-pureformulas.html PureFormulas Methyl Folate 1,000 mcg] PureFormulas</ref>). Unless one's diet is otherwise totally devoid of B<sub>9</sub>, taking this as directed will push one over the UL.
*Ortho Molecular Products' Folic Acid supplement contains 5000mg of folate, well over the UL<ref>[https://web.archive.org/web/20150104052737/http://www.orthomolecularproducts.com/folic-acid/ Folic Acid] Ortho Molecular Products</ref>
*High folate supplement use raises blood folate to high levels which increases the risk of prostate cancer.<ref>Wien TN, Pike E, Wisløff T, Staff A, Smeland S, Klemp M. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278486/ ''Cancer risk with folic acid supplements: a systematic review and meta-analysis'']. BMJ Open. 2012 Jan 12;2(1):e000653</ref><ref>Wang, R., Zheng, Y., Huang, JY. et al. (2014). [https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-1326 ''Folate intake, serum folate levels, and prostate cancer risk: a meta-analysis of prospective studies'']. BMC Public Health 14, 1326.</ref><ref>Jane C. Figueiredo, Maria V. Grau, Robert W. Haile, Robert S. Sandler, Robert W. Summers, Robert S. Bresalier, Carol A. Burke, Gail E. McKeown-Eyssen, John A. Baron. [https://academic.oup.com/jnci/article/101/6/432/997701 ''Folic Acid and Risk of Prostate Cancer: Results From a Randomized Clinical Trial'']. JNCI: Journal of the National Cancer Institute, Volume 101, Issue 6, 18 March 2009, pp. 432–435</ref><ref>Tio, M., Andrici, J., Cox, M. et al. [https://www.nature.com/articles/pcan201416 ''Folate intake and the risk of prostate cancer: a systematic review and meta-analysis'']. Prostate Cancer Prostatic Dis 17, 213–219 (2014).</ref><ref>[https://www.sciencedaily.com/releases/2009/03/090310161436.htm Folic Acid Supplements Linked To Higher Risk Of Prostate Cancer, Study Shows]</ref>
|-
|B<sub>12</sub>
|2.4 µg (M);<BR>2.4 µg (F)
|Pernicious anemia, neurological complications, gastrointestinal complaints
|none established
|Lung cancer (>55 µg)
|
*A large prospective epidemiology study found an increased risk of lung cancer for both smoking and non-smoking men (but not women) in those groups taking the highest doses of B<sub>12</sub> (>55 µg), but not lower dose groups.<ref name=osu/><ref name=brasky/>
|-
|Pantothenic acid (B<sub>5</sub>)
|5 mg (M);<BR>5 mg (F)
|Irritability & restlessness; fatigue; apathy; malaise; sleep disturbances; gastrointestinal complaints; neurobiological symptoms; hypoglycemia & increased sensitivity to insulin
|none established
|
|
|-
|Biotin (B<sub>7</sub>)
|30 µg (M);<BR>30 µg (F)
|Dermatitis, conjunctivitis, alopecia, central nervous system abnormalities
|none established
|
|
|-
|Choline
|550 mg (M);<BR>425 mg (F)
|Liver dysfunction
|3500 mg
|Body odor, sweating, and salivation; hypotension; hepatotoxicity
|High amounts of choline may increase the risk of prostate cancer.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441112/ Choline intake and risk of lethal prostate cancer: incidence and survival]</ref>
|-
|colspan=6|<center>'''Minerals'''</center>
|-
|[[Arsenic]]
|none established
|
|no justification for supplementation due to toxicity
|
|
|-
|Boron
|none established
|
|20 mg/day (M);<BR>20 mg/day (F)
|General systemic toxicity (implied by animal studies); dermatitis, alopecia, anorexia, indigestion (in humans)
|
|-
|[[Calcium]]
|1000-1200 mg/day (M);1000-1200 mg/day (F)
|Reduced bone mass, osteoporosis
|2000-2500 mg/day (M);<BR>2000-2500 mg/day (F)
|kidney stone formation, hypercalcemia, renal insufficiency, cancer
|
*Scientology/Narconon's "Purification Rundown" includes of doses of calcium up to 3000 mg<ref name=exposed/>
*Bob's Best Coral Calcium 2000 mg<ref>[http://archive.ph/kVFjN Bob's Best Coral Calcium 2000 mg] Robert Barefoot (archived from February 26, 2017)</ref> Unless one's diet is otherwise totally devoid of calcium, taking this as directed will push one over the UL.
*Taking calcium supplements at doses >2000 mg/day is associated with increased risk of total prostate cancer and lethal and high-grade cancers.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266887/ ]</ref> 
|-
|Chromium
|30-35 µg/day (M);<BR>20-25 µg/day (F)
|Weight loss, peripheral neuropathy, impairment of glucose utilization
|none established
|
|
|-
|Copper
|900 µg/day (M);<BR>900 µg/day (F)
|Liver damage
|10 mg/day (M);<BR>10 mg/day (F)
|Gastrointestinal illness
|
*Scientology/Narconon's "Purification Rundown" includes of doses of copper up to 12 mg<ref name=exposed/>
|-
|[[Fluoride]]
|4 mg/day (M);<BR>3 mg/day (F)
|Dental caries
|10 mg/day (M);<BR>10 mg/day (F)
|Enamel and skeletal fluorosis
|
|-
|[[Iodine]]
|150 µg/day (M);<BR>150 µg/day (F)
|Intellectual disability, hypothyroidism, goiter, cretinism, other growth and developmental abnormalities
|1100 µg/day (M);<BR>1100 µg/day (F)
|Burning of the mouth, throat, and stomach, abdominal pain, fever, nausea, vomiting, diarrhea, weak pulse, cardiac irritability, coma, cyanosis, goiter, thyroid cancer
|
*Joseph Mercola's Iodine supplement is above the UL at 1500 µg<ref>[https://archive.ph/SCI0e Iodine (30 per bottle): 30 Day Supply] Dr. Mercola Premium Products</ref>
*Ortho Molecular Products' Seleno-Iodide supplement contains 3000µg of iodine<ref>[http://www.orthomolecularproducts.com/seleno-iodide/ Seleno-Iodide] Ortho Molecular Products</ref>
*[[Alex Jones]]' InfoWars site sells "Survival Shield X-2 &mdash; Nascent Iodine", a liquid, with a serving size of 3 drops that gives 1950 µg of iodine,<ref>[http://web.archive.org/web/20170303062233/http://www.infowarsshop.com/Survival-Shield-X-2--Nascent-Iodine_p_1322.html Survival Shield X-2] ''Infowars Store'' (archived from March 3, 2017)</ref><ref name=gizmodo>[https://www.gizmodo.com.au/2015/02/the-online-store-where-preppers-buy-their-bullshit-cure-alls/ The Online Store Where Preppers Buy Their Bulls**t Cure-Alls] by Ashley Feinberg (Feb 18, 2015, 10:30am) ''Gizmodo''.</ref> nearly double the UL. The [[Edgar Cayce]]-inspired iodine treatment is supposed to combat [[water fluoridation]] (actually quite safe) as well as [[Water chlorination|water disinfection byproducts]] (very safe compared to the effects of ''not'' disinfecting) with an ineffective but potentially-toxic dose of iodine.<ref name=gizmodo/><ref>[https://web.archive.org/web/20170211055613/https://motherboard.vice.com/en_us/article/infowars-life How Alex Jones Uses Fear of the Government to Sell Diet Supplements] by Spenser Davis (Jul 22 2016, 6:00am) ''Motherboard Vice''.</ref><ref>[https://web.archive.org/web/20160204004306/https://www.infowars.com/fluoride-poison-on-tap-documentary Fluoride: Poison On Tap Documentary: Fluoride exposure can have serious health consequences] by Edward Group (November 17, 2015) ''Infowars'' (archived from February 4, 2016).</ref>
*Detoxadine also has a serving size of 1950 µg.<ref>[http://www.globalhealingcenter.com/nascent-iodine-detoxadine.html Detoxadine® Nascent Iodine Supplement] ''Global Healing Center''.</ref>
*[[Iodine tablets]] are sometimes recommended to prevent thyroid cancer from nuclear accidents. A small study on 8 volunteers showed effectiveness in preventing radioactive iodine uptake when the volunteers took 32,000 µg/day for 3 months.<ref name=lemar>[https://doi.org/10.1210/jcem.80.1.7829615 Thyroid adaptation to chronic tetraglycine hydroperiodide water purification tablet use] by H. J. LeMar et al. (1995) ''J. Clin. Endocrinol. Metab. 80(1): 220-223.</ref> The volunteers had temporarily increased thyroid size but no evidence of hyperthyroidism nor hypothyroidism.<ref name=lemar/>
|-
|[[Iron]]
|8 mg/day (M);<BR>8-18 mg/day (F)
|Reduced physical work capacity, delayed psychomotor development in infants, impaired cognitive function, anemia
|45 mg/day (M);<BR>45 mg/day (M)
|Vomiting, diarrhea, constipation
|
*Scientology/Narconon's "Purification Rundown" includes of doses of iron up to 108 mg<ref name=exposed/>
*Puritan's Pride: High Potency Slow Release Iron 45 mg<ref>[http://archive.ph/b2kos High Potency Slow Release Iron 45 mg] Puritan's Pride (archived from February 27, 2017)</ref> Unless one's diet is otherwise totally devoid of iron, taking this as directed will push one over the UL.
|-
|Magnesium
|400-420 mg/day (M);<BR>310-320 mg/day (F)
|Hypocalcemia, neuromuscular hyperexcitability
|350 mg/day (M);<BR>350 mg/day (F){{efn|Unlike the other values in the table, the UL for magnesium is for supplementation only, hence a comparable UL for magnesium would be the DRI plus the stated UL.}}
|Diarrhea, nausea, abdominal cramping
|
*Mendelian randomization analyses have found that higher magnesium levels are associated with an increased risk of breast cancer.<ref>[https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-03018-y An atlas of associations between 14 micronutrients and 22 cancer outcomes: Mendelian randomization analyses]. bmcmedicine.biomedcentral.com.</ref><ref>[https://www.wcrf.org/vitamins-minerals-and-their-link-to-breast-cancer/ Vitamins, minerals, and their link to breast cancer]. wcrf.org.</ref>
*Joseph Mercola's Magnesium L-Threonate supplement is at well above the UL at >2000 mg<ref>[https://archive.ph/RhkVb Magnesium L-Threonate (90 per bottle): 30 Day Supply] Dr. Mercola Premium Products</ref>
*Scientology/Narconon's "Purification Rundown" includes of doses of magnesium up to 1500 mg<ref name=exposed/>
*Global Healing Center's Oxy-Powder (sold as "Advanced Liver Cleanse Pack" on InfoWars) contains 1537 mg per serving<ref>[https://web.archive.org/web/20151204015224/http://www.infowarsstore.com/advanced-liver-cleanse-pack.html Advanced Liver Cleanse Pack] ''InfoWars''</ref>
*Carlson® Magnesium 350 mg<ref>[http://archive.ph/8app2 Carlson® Magnesium 350 mg] GNC (archived from February 27, 2017)</ref>Unless one's diet is otherwise totally devoid of magnesium, taking this as directed will push one over the UL for women.
|-
|Manganese
|2.3 mg/day (M);<BR>1.8 mg/day (F)
|Impaired growth, impaired reproductive function, impaired glucose tolerance (based on animal studies)
|11 mg/day (M);<BR>11 mg/day (F)
|Neurotoxicity
|
*Scientology/Narconon's "Purification Rundown" includes of doses of manganese up to 24 mg<ref name=exposed/>
|-
|Molybdenum
|45 µg/day (M);<BR>45 µg/day (F)
|Molybdenum deficiency has not been observed in healthy people.
|2000 µg/day (M);<BR> 2000 µg/day (F)
|Reduced growth or weight loss, renal failure, skeletal abnormalities, infertility, anemia, diarrhea, and thyroid injury (based on animal studies)
|
|-
|Nickel
|none established
|
|1 mg/day (M);<BR>1 mg/day (F)
|Reduced growth, weight loss, renal failure, skeletal abnormalities, infertility, anemia, diarrhea, and thyroid injury
|
|-
|Phosphorus
|45 mg/day (M);<BR>45 mg/day (F)
|Hypophosphatemia
|4000 mg/day;<BR>4000 mg/day
|Hyperphosphatemia
|
|-
|Selenium
|55 µg/day (M);<BR>55 µg/day (F)
|Keshan disease, Kashin-Beck disease
|400 µg/day (M);<BR>400 µg/day (F)
|Chronic selenosis
|
*Good State Liquid Ionic Selenium Minerals Supplement, (96 days at 400mcg.)<ref>[http://archive.ph/RpWKT Good State Liquid Ionic Selenium Minerals Supplement] Amazon.com (archived from February 27, 2017)</ref> Unless one's diet is otherwise totally devoid of selenium, taking this as directed will push one over the UL.
*[[Richard A. Passwater]] promoted selenium supplements at (200 µg/day).
*An unidentified selenium supplement was reported to have 200 times the labeled amount, causing acute selenium poisoning (median daily ingestion was 41.6 mg/day).<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225252/ Acute Selenium Toxicity Associated With a Dietary Supplement] by Jennifer K. MacFarquhar et al. ''Arch. Intern. Med. 2010 Feb 8; 170(3): 256–261. doi:10.1001/archinternmed.2009.495.</ref>
*Selenium supplementation in high doses is not recommended as it may increase the risk of prostate cancer.<ref>[https://www.fredhutch.org/en/news/center-news/2014/02/vitamin-e-selenium-prostate-cancer-risk.html Vitamin E, selenium linked to increased prostate cancer risk]</ref><ref>[https://www.health.harvard.edu/blog/selenium-vitamin-e-supplements-increase-decrease-prostate-cancer-risk-201402287059 Selenium, vitamin E supplements increase prostate cancer risk]</ref><ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296194/ Selenium Supplementation and Prostate Cancer Mortality]</ref>
|-
|Silicon
|none established
|
|none established
|
|
|-
|Vanadium
|none established
|
|1.8 mg/day (M);<BR>1.8 mg/day (F)
|"Although vanadium in food has not been shown to cause adverse effects in humans, there is no justification for adding vanadium to food, and vanadium supplements should be used with caution."
|
|-
|Zinc
|11 mg/day (M);<BR>8 mg/day (F)
|Diverse symptoms
|40 mg/day (M);<BR>40 mg/day (F)
|
*Epigastric pain, nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, headaches
*Zinc supplementation of more than 75 mg per day or over 15 years may substantially increase risk of lethal prostate cancer.<ref>[https://link.springer.com/article/10.1007/s10654-022-00922-0 Zinc supplement use and risk of aggressive prostate cancer: a 30-year follow-up study] by Yiwen Zhang et al. (2022) ''European Journal of Epidemiology'' 37:1251–1260. doi:10.1007/s10654-022-00922-0.</ref>
|
*Scientology/Narconon's "Purification Rundown" includes of doses of zinc up to 90 mg<ref name=exposed/>
*Mason Natural Zinc, 100mg, Tablets<ref>[http://archive.ph/UhjJz Mason Natural Zinc, 100mg, Tablets] Amazon.com (archived from February 27, 2017)</ref>
*Ortho Molecular Products' Reacted Zinc supplement contains 54mg of zinc<ref>[https://web.archive.org/web/20150108044633/http://www.orthomolecularproducts.com/file.aspx?DocumentId=601 Reacted Zinc] Ortho Molecular Products</ref>
|-
|Potassium
|4700 mg/day (M);<BR>4700 mg/day (F)
|Hypokalemia, high blood pressure, cardiovascular disease, bone demineralization, kidney stones
|none established
|
|
|-
|Sodium
|1300-1500 mg/day (M);<BR>1200-1500 mg/day (F)
|Adverse effects on blood lipids, insulin resistance
|2300 mg/day (M);<BR>2300 mg/day (F)
|Increased blood pressure, cardiovascular disease
|
|-
|Chloride
|1800-2300 mg/day (M);<BR>1800-2300 mg/day (F)
|correlated with sodium
|3600 mg/day (M);<BR>3600 mg/day (F)
|correlated with sodium
|
|}

==Searching for my mainline==
Physician John A. Myers {{lived||1984}} started injecting some of his patients with vitamin cocktails (the "Myers's Cocktail") in the 1960s to treat patients with asthma, migraines and fibromyalgia.<ref name=das>[https://www.washingtonpost.com/wellness/2022/02/24/warnings-about-drip-bars/ Trendy IV vitamin infusions don’t work — and might be unsafe. Experts explain why.] by Lala Tanmoy Das (February 24, 2022) ''The Washington Post''.</ref> There is no evidence that the cocktail is effective for any of these ailments.<ref name=das/><ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894814/ Intravenous micronutrient therapy (Myers' Cocktail) for fibromyalgia: a placebo-controlled pilot study] by Ather Ali (2009) ''J. Altern. Complement. Med.'' 15(3):247-57. doi:10.1089/acm.2008.0410.</ref> Worse yet, no one knows what Myers' formulation was.<ref>[https://web.archive.org/web/20201029134106/http://archive.foundationalmedicinereview.com/publications/7/5/389.pdf Intravenous Nutrient Therapy: The “Myers’ Cocktail”] by Alan R. Gaby (2002) ''Alternative Medicine Review'' 7(5):389-403 (archived from October 29, 2020).</ref>{{rp|389}} There are very specific reasons why injection of vitamins might be medically advisable (e.g., for premature babies).<ref name=das/> However, careless medical use of vitamin injections under medical supervision has resulted in patient deaths and in disciplinary action against the physician involved.<ref>[https://quackwatch.org/cases/board/med/oneal/ Disciplinary Action against Kenneth O’Neal, M.D.] by Stephen Barrett (September 23, 2013) ''Quackwatch''.</ref> The potential risks with no known benefit make non-medically supervised injections highly inadvisable.<ref name=das/> In 2018, vitamin injection started getting [[Appeal to celebrity|popularized by celebrities]] Chrissy Teigen and usual suspect [[Gwyneth Paltrow]].<ref name=das/>

==Resources==
If you need to take a vitamin supplement it's worth remembering that there are degrees of how good a product is. So, always err on the side of caution. With that in mind, the following is a list of websites which monitor the quality of supplements (including vitamin supplements) and the claims of their makers.
*The American Journal of Clinical Nutrition: (http://www.ajcn.org)
*Consumer Lab: (https://www.consumerlab.com)
*[[Food and Drug Administration]]: (http://www.fda.gov/Food/DietarySupplements/)
*Institute of Food Technologies: (https://www.ift.org/)
*Medline Database: (https://www.nlm.nih.gov/medlineplus/)
*National Institutes of Health, Office of Dietary Supplements: (https://ods.od.nih.gov/)
*Supplement Watch: (http://www.supplementwatch.info/Vitamins/ListOfVitamins.html)
*Vox's supplement database (http://www.vox.com/a/supplements)

==See also==
*[[Gary Null]] — overdosed on vitamin D by consuming his own brand of supplements, allegedly misformulated at 1000 times the labelled amount
*[[Herbal supplement]]
*[[Nutritional supplement]]
*[[Bodybuilding woo]]

==External links==
*[http://www.livescience.com/36045-vitamin-colds.html Does Vitamin C Really Help Colds?] by Lauren Cox (December 21, 2011 10:18am ET) ''Live Science''.
* [[YouTube]] {{---}} [https://www.youtube.com/watch?v=mZ6nREONy_4 A Boy Ate 150 Gummy Vitamins For Breakfast. This Is What Happened To His Bones.]

==Notes==
{{reflist|group=note|2|90%}}

==References==
{{reflist|2|90%}}

{{foodbox}}
[[Category:Chemicals]]
[[Category:Diet woo]]
[[Category:Food supplement woo]]

Categories: Chemicals, Diet woo, Food supplement woo