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Lucinda's Pearls: Nutritional Supplementation

Lucinda Harms, RPh, is the director of pharmacy at CarePro Compounding and Advance Health.

There are a number of good reasons why taking nutritional supplements is a good idea. I have listed some of the rationale that you should keep in mind when considering whether they would be a good idea for your patients, customers, family members and even for yourself.

  1. Dietary Deficiencies: The typical American diet contains relatively large quantities of nutrient-depleted refined sugar and white flour. In addition, modern farming techniques have resulted in a decrease in the nutrient content of many foods. Between 1940 and 2000 the average content of certain micronutrients in plant foods declined as follows: magnesium 21-35% iron 15-32% copper 81% riboflavin 38%.
  2. Absorption defects: Nutrient malabsorption is often seen in people with gastrointestinal diseases, hypochlorhydria, small bowel bacterial overgrowth and pancreatic enzyme deficiency. Among healthy people, the absorption of beta carotene varied by more than 40 fold.
  3. Transport Defects: Some people have a defect in the transport of B12 across the blood-brain barrier, resulting in low concentrations in the cerebral spinal fluid. This can cause a neuropsychiatric disorder called cerebral folate deficiency.
  4. Renal Wasting: Gitelman’s syndrome is an example of a congenital disorder that results in excretion of excessive amounts of magnesium and potassium. Treatment includes potassium and magnesium supplements.
  5. Enzyme Defects: Approximately 50 inherited enzyme defects have been described in which supplementations with a vitamin produces biochemical and clinical improvement. In 1/3 of these there is decreased binding affinity for the vitamin coenzyme which can be overcome by increasing the concentration of the vitamin. Impaired conversion of a vitamin to its active coenzyme form can also lead to an increased requirement for the vitamin.
  6. Genetic polymorphisms: The existence of a number of rare, but serious, genetic diseases raises the possibility that similar, but milder, nutrient-responsive inborn errors of metabolism occur more commonly. It is estimated that 5-15% of Americans and Europeans have a polymorphism of the 5,10-methylenetetrahydrofolate reductase gene which causes hyperhomocysteinemia which is corrected by increasing folate intake.
  7. Effects of disease: Nutrient requirements may be increased in various disease states. Patients with congestive heart failure have an impaired ability to take up magnesium from serum into myocardial tissue. This can be overcome in part by increasing serum concentrations of magnesium. Nutrient requirements are increased in disease states that result in increased metabolic rate, such as COPD and hyperthyroidism.
  8. Drug-induced nutrient deficiencies: Treatment with certain medications has been found to promote nutritional deficiencies. Supplementation can also effective in some instances of preventing and treating side effects of drugs.(ie NSAIDs and copper)
  9. Pharmacological and physicochemical effects: A number of different nutrients have been found to have a pharmacological or physicochemical effect when present in the body in concentrations greater than needed to prevent deficiency. For example, vitamin C at high concentrations has virucidal and antibacterial effects and magnesium can increase the solubility of calcium oxalate.

Nine good reasons to take your nutritional supplements!