I am currently working towards becoming a Certified Nutrition Specialist (CNS) that requires 1,000 supervised hours in addition to passing the CNS exam, so I have lots of studying to do! I thought creating a vitamin and mineral table would be a helpful practice for me, but also as an educational resource for others. Today, I'll start with an introduction to vitamins, minerals to come later, and what to look for when shopping for supplements. Eventually, I will grant each of these babies a post of their own.

Just a heads-up, this information is dense and I am barely grazing the surface of the amazing capabilities of all the necessary nutrients our body needs for everyday/optimal function. I am not going to go into detail about each metabolic process the vitamins are involved in (because it would take forever to write and read) and will be using a lot of scientific/medical/chemistry terminology, if you don't know what the word is- that's okay! When I first started grad school, I was so overwhelmed with the wording! If you have questions, ask me or our trusty friend google.

First, let's talk about vitamin/mineral supplementation. I want to start off by saying that not all supplements are created equally! Unfortunately, it isn't the easiest system to navigate and often times the best supplements cost a pretty penny. I also want to throw it out there that just because one supplement did wonders for a friend does not mean that you will have the same results- while are bodies may look similar, they are all vastly different, it's called bio-individuality. Our genetics are different, our internal and external environments are different, stressors, lifestyles, etc.

While this post will provide some guidance towards supplement shopping; as a consumer it is so important for you to do your own research, understand if there are any risks/side effects or reactions with a supplement in general or in regards to other supplements, herbs or medications you may be taking and then determine if it is something your body needs/may benefit from. If it is too overwhelming or you are unsure, I highly recommend that you chat with either a doctor or a nutritionist (like me), before starting a new supplement.

Supplements are recommended in cases where people may be missing nutrients in their diet (like vegan/vegetarian), for those with unhealthy diets that are missing out on a lot of essentials or to help boost certain bodily functions. According the the National Health and Nutrition Examination Survey (NHANES), approximately 40% of Americans over the age of 2 do not consume the recommended amount of Vitamin D, calcium, Vitamin A, Vitamin C, Vitamin E, thiamin, folate and magnesium, which adds up to be over 100 million people (2).

As you have maybe heard, the FDA does not approve dietary supplements before they hit the shelves, they only become involved after someone gets sick from taking said supplement. However, there is a group called USP that has a set of standards and verification process to ensure the dietary supplements claims are correct, that the product is safe, that the ingredients listed are in the product and meet the rest of their requirements. Verified supplements will have a USP stamp on the front of the bottle. Additionally, there are supplement distribution companies like Emerson Ecologics, that have their own quality assurance program and distribute supplements that meet their set of standards.

When choosing a supplement, ideally, we'd have a product that's organic, made from whole foods or safe, bio-active synthetic ingredients, there's no additives like artificial coloring or fillers and it has been tested for effectiveness. My biggest concern with supplements is products that use the cheapest form of nutrient that are often not absorbed or usable within the body.

Some brands I like are Garden of Life, Thorne, Nordic Naturals, Gaia, Designs for Health and Douglas Laboratories.

Vitamins

Vitamins break down into two categories- fat soluble and water soluble. A fat-soluble vitamin that is absorbed with fats from our diet and is stored in fat tissues within the body, which where the risk of toxicity could be an issue, if you're taking anything in excess or under special circumstances. It is best to pair fat-soluble vitamins/foods with a meal or snack that contains healthy fats like ghee, nuts and seeds, fish, etc.

A water-soluble vitamin can be dissolved in water and is carried to tissues, but we do not store them within the body. Excess water-soluble vitamins are excreted with our bodily waste, hence why you have to continue eating a healthy and balanced diet.

Below I have included each vitamin, their food sources, a little bit about their function, the RDA for adult stages (RDA can differ throughout the lifecycle, sex, pregnancy and other conditions), notes about deficiencies/toxicities (if they exist/or are common), and any drug or nutrient interactions.

*Many medications can decrease absorption of certain vitamins or require precaution with other nutrients due to interactions. As you'll notice, hormonal birth control decreases the absorption/availability of many B Vitamins and more, so a multivitamin or nutrient dense diet is recommended for those taking it- something they don't often tell us at the doctors office.

Vitamin Table

Vitamin A- Fat soluble. Preformed A found in animal products like beef liver, eggs, shrimp, fish and dairy products. Beta- carotene and other carotenoids are precursors to Vitamin A can be found in plants like sweet potatoes, carrots, pumpkins, squash, spinach and peppers.
- Important for eye health, plays a role in bone growth and the immune system, gene expressions, skin integrity, white blood cell development and production of red blood cells. Best absorbed alongside fat since it is fat soluble.
- RDA- Adult Females- 700 mcg/day : Adult Males- 900 mcg/day
- Toxicity- overconsumption of preformed A can lead to Hypervitaminosis A and acute toxicity is rare but includes symptoms like nausea, headache, fatigue, loss of appetite, dry skin and dizziness, while chronic has similar symptoms plus itchy skin, cerebral edema, bone and joint pain.
- Drug/Nutrient Interactions- May exacerbate an iron deficiency. Fiber reduces absorption of Vitamin A. Chronic alcohol consumption depletes liver stores. Retinoids used in pharmaceuticals can lead to side effects, toxicity and birth defects when used during pregnancy (1,2,6)
Vitamin B1/Thiamin- Water Soluble. Found in pork, whole grains, legumes, tuna, beef and soy milk. Be careful not to overcook these foods as it will reduce the Thiamin content. Alcohol can decrease absorption.
- Is a coenzyme for the metabolism of carbohydrates and branched-chain amino acids, involved in Krebs cycle, DNA & RNA synthesis & nerve function
- RDA- Adult Females- 1.1 mg/day : Adult Males- 1.2mg/day
- Deficiency can cause Beriberi and Wernicke- Korsakoff syndrome
- Drug/Nutrient Interactions- Anticonvulsants may decrease Vitamin B1, oral contraceptives can cause deficiency and furosemide diuretics can increase deficiencies (2,3,6)
Vitamin B2/Riboflavin- Water Soluble. Found in animal products like dairy, eggs, meats and organ meats. Also legumes, green leafy vegetables, fruits and cereals. B2 can also be inactivated with exposure to sunlight. High doses of Riboflavin is what causes bright yellow urine, that you may have seen after taking vitamins.
- Essential part of coenzymes involved in redox reactions, energy production, cellular function, growth and development, metabolism of fats, drugs and steroids.
- RDA- Adult Females- 1.1 mg/day : Adult Males- 1.3mg/day
- Consuming calcium with meals containing B2 decrease absorption
- Deficiency is rare in the US, but can occur with endocrine disorders
- Drug-Nutrient Interactions- Tricyclic antidepressants can inhibit absorption, oral contraceptives can decrease B2 status, anticonvulsants increase urinary excretion (2,4,6)
Vitamin B3/Niacin- Water soluble. Found in fish, chicken, beef, liver, enriched cereals, whole grains, seeds, legumes, coffee, tea, green vegetables and milk.
- Required for energy metabolism- coenzyme for redox reactions. Not necessarily an essential nutrient because our body can produce niacinamide from the amino acid, tryptophan.
- RDA- Adult Females- 14 mg/day : Adult Males- 16 mg/day
- Deficiency is known as Pellagra and is referred to as the three "D"s - sun sensitive dermatitis, diarrhea and dementia, mostly associated with malnutrition
- Drug-Nutrient Interactions- Long term use of anticonvulsants can cause deficiency (2,5,6)
Vitamin B5/Pantothenic Acid- Found rich in liver, yeast, egg yolk and broccoli. Fish, shellfish, chicken, dairy, mushrooms, avocados, sweet potatoes and whole grains are considered good sources.
- Required for the synthesis of Coenzyme A (necessary for several chemical reactions),
- RDA- Adult Female & Males- 5 mg/day
- Deficiency & Toxicity is rare in humans
- Drug-Nutritient Interactions- Copper deficiency can increase B5 levels in diet. Oral contraceptives with estrogen and progestin increase B5 needs (2,6)
Vitamin B6- water soluble. Found in animal products, legumes, soy products, potatoes, bananas and watermelons
- Found in three compound forms- pyroxidal, pyridoxine and pyridoxamine that are precursors to the bio-active form pyroxidal-5-phosphate that is a coenzyme for 100 different enzymatic reactions that are involved in transamination, dehydration, gluconeogenesis, helps to convert tryptophan to niacin and serotonin and production of red blood cells
- RDA- Adults Females- 1.5 mg/day : Adult Males- 1.7 mg/day
- A synthetic form, Pyroxidine HCL, is the common form found in supplements, but is more bioavailable than food sources.
- Risk of deficiency in the elderly and with alcohol abuse- can cause confusion, depression, anxiety, headache and stomach pain
- Drug-Nutrient Interactions- Oral contraceptives deplete B6 and some anti-epileptic drugs can lead to low plasma levels of B6 and lead to high homocysteine levels (2,6,7,8)
Vitamin B7/Biotin- Water soluble. Found in meat, fish, egg yolks, organ meats, nuts and seeds, sweet potatoes, broccoli, yeast, raspberries, cauliflower, avocado and chard. Helps with hair and nail strength
- Cofactor for five carboxylases that are important in metabolic reactions like fatty acid metabolism, amino acid catabolism and gluconeogenesis. Biotin is also synthesized by the gut bacteria in the large intestine
- RDA- Adult Female & Males- 30 mg/day
- Drug-Nutrient Interactions- Avidin in raw egg whites binds to biotin, making it unable to absorb in the body, cooking eggs denatures avidin. Anticonvulsants lead to low levels of plasma biotin and increased urinary output. Antibiotics may decrease synthesis of biotin (6,9)
Vitamin B9/Folate/Folic Acid- Water Soluble. Found in beef liver, spinach and green leafy vegetables, fortified cereals, mushrooms, legumes, avocados, strawberries, oranges and more. Raw form will be higher than cooked.
- Involved in the metabolism of some amino acids and nucleotides and in DNA synthesis. Insufficiency during early pregnancy is associated with neural tube defects
- RDA- Adult Females & Males- 400 mcg/day
- Deficiency can occur with alcoholism, conditions associated with cell division, metabolism and malabsorption
  - Side note: In order to use folate within the body, we need the enzyme methylenetetrahydrofolate reductase (MTHFR). However, there is a single-nucleotide polymorphism (SNP) called MTHFR mutation, where some individuals are unable to produce or produce less of this enzyme necessary for the use of Folate & B12, thus a potential cause for deficiency. You can determine if you have this mutation through any of the genetic tests out there like 23andme or Ancestry, or ask your doctor to test your homocysteine levels. If you do have this mutation, please work with a doctor, nutritionist or dietician familiar with this mutation that can help you receive the proper supplementation.
- Drug-Nutrient Interactions- anticonvulsants interfere with absorption, NSAIDs interfere with metabolism and oral contraceptives may cause deficiency. Folate decreases zinc absorption, synthetic folic acid intake has the ability to mask a B12 deficiency (2,6,10)
Vitamin B12/Cobalamin- Water soluble. Found almost only in animal products like meat, fish and seafood, dairy, eggs, poultry, fortified cereals and soy milk. Supplementation is necessary if you are vegan/vegetarian!
- Acts as a cofactor for methionine synthase and L-methylmalonyl-CoA mutase, regulates homocysteine levels in the blood, necessary for red blood cell formation, neurological function and DNA synthesis. In order to utilize the B12 from food, our body requires stomach acid, pepsin and intrinsic factor (a complicated process and why you sometimes hear about/see people receiving B12 injections)
- RDA- Adult Male & Females: 2.4 mcg/day
- Deficiency results in megaloblastic anemia, fatigue, weakness, constipation, loss of appetite and weight loss. Pernicious anemia is an autoimmune disease that results in a failure to produce intrinsic factor causing B12 malabsorption, which will eventually lead to a deficiency if left untreated.
- Drug-Nutrient Interactions- Oral contraceptives cause depletion of B12 and H2 blockers, metformin and proton pump inhibitors (PPIs) inhibit the absorption from food (2,6,11)

Vitamin C- Water soluble. Found in fruits and vegetables like asparagus, citrus fruits, cauliflower, fortified cereals, potatoes, broccoli, bell peppers, strawberries, tomatoes, etc.
- Plays a big role in collagen (hello healthy skin), tyrosine and neurotransmitter synthesis, is an important antioxidant and also regenerates other antioxidants in the body like Vitamin E, is involved in protein metabolism, may help delay or prevent the development of some cancers and boosts the immune system.
- RDA- Adult Females: 75 mg/day *Smokers- 110 mg/day : Adult Males: 90 mg/day *Smokers- 125 mg/day
- Acute deficiency leads to scurvy and includes symptoms of fatigue and inflamed/bleeding gums. As deficiency progresses, collagen production slows and connective tissues weaken leading to joint pain and poor wound healing
- Drug-Nutrient Interactions- Vitamin C enhances the absorption of non-heme iron (from plants). Oral contraceptives with estrogen deplete Vitamin C, aspirin increases urinary excretion of Vitamin C, Vitamin C also increases the the absorption of aluminum when taking aluminum containing antacids (2,6,12)
Vitamin D- Fat soluble. The body is able to synthesize it's own Vitamin D from absorption of sunlight through the skin, but is not available in many foods naturally. Foods like fish liver oil, salmon, tuna, swordfish, sardines, beef liver, eggs, mushrooms and fortified foods contain large-small amounts of Vitamin D. Some researchers suggest that 5-30 minutes of sun exposure between 10 AM-3 PM with exposed face, arms, legs or back, without sunscreen, at least two times a week should create an appropriate amount of Vitamin D production. Time of year, geographic location, skin exposure, SPF, cloud, smog and melanin all affect sun exposure.
- Vitamin D regulates gene expression, helps with insulin secretion, the immune system and blood pressure regulation. Vitamin D also helps with calcium absorption in the gut and is necessary for bone growth and remodeling
- RDA- Adults: 600 IU (International Units)
- Many people do not receive enough of the vitamin due to its lack of presence in foods and minimal time spent outdoors, because of this supplementing is necessary for a lot of people, especially if you do not consume fish or dairy products, and this is a vitamin you do not want to miss out on!
- Drug-Nutrient Interactions- Corticosteroid medications may reduce calcium absorption and reduce Vitamin D synthesis. Some cholesterol-lowering drugs and the weight loss drug orlistat can reduce the absorption of Vitamin D (2,13)
Vitamin E- Fat soluble. Found in oils like sunflower, safflower, corn and soybean oil, leafy green vegetables, egg yolks, whole grains and nuts and seeds.
- Vitamin E comes in a number of different forms but the main form Is Alpha-tocopherol and a variety of the forms are referred to as "mixed" tocopherols. Vitamin E is an antioxidant that protects the cells free radicals, which can contribute to cancer and cardiovascular disease, from smoking and toxins we are exposed to in our environment. It also plays a role in the immune system, regulation of gene expression
- RDA- Adult Females & Males: 15 mg/day
- Drug-Nutrient Interactions- Large doses of Vitamin E can increase the risk of bleeding when taking anticoagulant, NSAIDs and anti platelet medications (2,14)
Vitamin K- Fat soluble. Two forms, K1 & K2. K1 is the main form, found in dark, leafy greens like spinach, collard greens, broccoli, etc. and K2 is synthesized by bacteria in the gut and found in fermented foods like natto, cheese, liver, eggs, butter and meat.
- Vitamin K acts as a coenzyme for Vitamin-K dependent carboxylase that is necessary for the production proteins involved in blood and bone metabolism
- RDA- Adult Females: 90 mcg/day : Males: 120 mcg/day
- Drug-Nutrient Interactions- High levels of Vitamin K can inhibit anticoagulants, antibiotics can destroy the bacteria that produce Vitamin K and bile acid sequestrants can reduce the absorption of Vitamin K (2,15)

References:

(1) https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/

(2) Guilliams, T.G. (2017) Supplementing dietary nutrients: A guide for healthcare professionals. Point Institute. Thomas G. Guilliams: USA

(3) https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/

(4) https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/

(5) https://lpi.oregonstate.edu/mic/vitamins/niacin

(6) https://www.health.harvard.edu/staying-healthy/listing_of_vitamins

(7) Palmery, M., Saraceno, A., Vaiarelli, A. & Carlomagno, G. (2013). Oral contraceptives and changes in nutritional requirements. European Review for Medical and Pharmacological Services, 17(13): 1804-1813

(8) https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/

(9) https://ods.od.nih.gov/factsheets/Biotin-HealthProfessional/

(10) https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

(11) https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

(12) https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

(13) https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

(14) https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/

(15) https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/